A Case of Perforated Sigmoid Colon Cancer within an Irreducible Inguinal Hernia

Abstract

An 81-year-old male was found to have a right inguinal hernia with sigmoid colon cancer within the hernia, and surgery was scheduled. However, a right common iliac aneurysm was found on preoperative testing, and aneurysm treatment was prioritized. On day 2 after stenting, the patient developed inguinal distention, abdominal pain, and vomiting, and computed tomography showed perforation of the incarcerated colon inside the hernia sac. Emergency surgery was performed through an inguinal incision. The incarcerated sigmoid colon was perforated, and the hernia sac was filled with intestinal fluid. To reduce the invasiveness of surgery, Hartmann's procedure was performed though an incision in the inguinal region, and the inguinal hernia was repaired using the Bassini method. This type of inguinal hernia incarceration rarely occurs in patients with colorectal cancer and/or perforation. As this patient was elderly and in poor general condition, an incision was only made in the inguinal region, and a sigmoidostomy was performed instead of anastomosis. His subsequent progress was relatively favorable.