Transverse Colon Necrosis Secondary to Strangulated Right Inguinoscrotal Hernia: A Rare Surgical Emergency

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Hauptverfasser: Ettaoussi Abdelhak, El Mkhalet Majda, Adri Hamza, Bouali Ichrak, Kamal Khadija, Abdessamad Majd, Bouali Mounir, El Bakouri Abdelillah, El Hattabi Khalid
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Sprache:Englisch
Veröffentlicht: Zenodo 2026
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author Ettaoussi Abdelhak
El Mkhalet Majda
Adri Hamza
Bouali Ichrak
Kamal Khadija
Abdessamad Majd
Bouali Mounir
El Bakouri Abdelillah
El Hattabi Khalid
author_facet Ettaoussi Abdelhak
El Mkhalet Majda
Adri Hamza
Bouali Ichrak
Kamal Khadija
Abdessamad Majd
Bouali Mounir
El Bakouri Abdelillah
El Hattabi Khalid
contents <p>Background: Inguinoscrotal hernias are common in elderly males. Although incarceration and strangulation are well-known complications, involvement of the transverse colon with subsequent necrosis remains uncommon and may present without classical signs of bowel obstruction.<br>Case Presentation: We report the case of a 71-year-old male, chronic smoker (40 pack-years), with a one-year history of a progressively enlarging right inguinoscrotal hernia. The hernia became irreducible and painful 24 hours prior to admission, without cessation of flatus or stool and without bowel transit disturbance. On examination, the patient was hemodynamically stable and afebrile. Abdominal examination revealed a painful, irreducible, non-expansile right inguinoscrotal hernia without inflammatory skin changes. Emergency surgery revealed a small amount of reactive peritoneal fluid and necrosis of the mid-transverse colon after reduction of the hernia contents. A segmental transverse colectomy with resection of necrotic greater omentum was performed, followed by a diverting transverse colostomy (Bouilly–Wolkman procedure). Hernia repair was completed using the Bassini technique. The remainder of intra-abdominal exploration was unremarkable.<br>Conclusion: Strangulated inguinoscrotal hernia may occur without classical obstructive symptoms. Early surgical exploration remains mandatory in irreducible painful hernias, even in the absence of bowel obstruction signs, to prevent catastrophic complications such as colonic necrosis.</p>
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spellingShingle Transverse Colon Necrosis Secondary to Strangulated Right Inguinoscrotal Hernia: A Rare Surgical Emergency
Ettaoussi Abdelhak
El Mkhalet Majda
Adri Hamza
Bouali Ichrak
Kamal Khadija
Abdessamad Majd
Bouali Mounir
El Bakouri Abdelillah
El Hattabi Khalid
Inguinoscrotal hernia, Strangulation, Transverse colon necrosis, Emergency surgery, Bassini repair
<p>Background: Inguinoscrotal hernias are common in elderly males. Although incarceration and strangulation are well-known complications, involvement of the transverse colon with subsequent necrosis remains uncommon and may present without classical signs of bowel obstruction.<br>Case Presentation: We report the case of a 71-year-old male, chronic smoker (40 pack-years), with a one-year history of a progressively enlarging right inguinoscrotal hernia. The hernia became irreducible and painful 24 hours prior to admission, without cessation of flatus or stool and without bowel transit disturbance. On examination, the patient was hemodynamically stable and afebrile. Abdominal examination revealed a painful, irreducible, non-expansile right inguinoscrotal hernia without inflammatory skin changes. Emergency surgery revealed a small amount of reactive peritoneal fluid and necrosis of the mid-transverse colon after reduction of the hernia contents. A segmental transverse colectomy with resection of necrotic greater omentum was performed, followed by a diverting transverse colostomy (Bouilly–Wolkman procedure). Hernia repair was completed using the Bassini technique. The remainder of intra-abdominal exploration was unremarkable.<br>Conclusion: Strangulated inguinoscrotal hernia may occur without classical obstructive symptoms. Early surgical exploration remains mandatory in irreducible painful hernias, even in the absence of bowel obstruction signs, to prevent catastrophic complications such as colonic necrosis.</p>
title Transverse Colon Necrosis Secondary to Strangulated Right Inguinoscrotal Hernia: A Rare Surgical Emergency
topic Inguinoscrotal hernia, Strangulation, Transverse colon necrosis, Emergency surgery, Bassini repair
url https://doi.org/10.5281/zenodo.19276676