Asian Journal of Case Reports in Surgery

An Acute Strangulated Inguinal Hernia in an Elderly Female: A Case Report

Someswara Rao Meegada *

Department of General Surgery, BHEL General Hospital, BHEL, HPEP Unit, Hyderabad, Telangana, India.

Bithika Noah

Department of General Surgery, BHEL General Hospital, BHEL, HPEP Unit, Hyderabad, Telangana, India.

*Author to whom correspondence should be addressed.

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Abstract

Acute strangulated inguinal hernia is uncommon in females. We report a case of an inguinal hernia with small bowel strangulation in a 76-year-old woman with a history of chronic constipation and abdominal straining. The forward stooping posture, a weak abdominal wall along with continuous abdominal straining resulted in a complicated acute inguinal hernia. Our case etiology could be multifactorial with findings similar to direct inguinal hernia, sportsman’s hernia, acute hernia, and Para pubic hernia. Irrespective of its etiology, our case was an acute strangulated inguinal hernia superimposed over a weak posterior inguinal wall strangulated at the level of the superficial inguinal ring. An open hernia repair was done without bowel resection. Chronic abdominal straining is a risk factor for acute hernias in elderly females. Inguinal hernias in elderly women must be operated on as early as possible due to the risk of strangulation.

Keywords: Acute, hernia, inguinal, female, direct, sportsman’s

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References

Köckerling F, Koch A, Lorenz R. Groin hernias in women-a review of the literature. Front Surg. 2019;6:4.

Zaki HA, Shaban EE, Zahran A, Bashir K, Elmoheen A. A rare presentation of small bowel obstruction due to obstructed indirect inguinal hernia. Cureus. 2021;13(12).

Dahlstrand U, Wollert S, Nordin P, Sandblom G, Gunnarsson U. Emergency femoral hernia repair: A study based on a national register. Ann Surg. 2009;249(4):672-676.

Kamat M, Singh N, Nattey K. A rare encounter of obstructed direct inguinal hernia of sliding variety. Int J Surg Case Rep. 2018;49:209-214.

Paksoy M, Sekmen Ü. Sportsman hernia; the review of current diagnosis and treatment modalities. Ulus Cerrahi Derg. 2015;32(2):122-129.

Brown A, Abrahams S, Remedios D, Chadwick SJ. Sports hernia: A clinical update. Br J Gen Pract. 2013;63(608):e235-7.

Kesek P, Ekberg O. Herniography in women under 40 years old with chronic groin pain. Eur J Surg. 1999;165(6):573-578.

Morales-Conde S, Socas M, Barranco A. Sportsmen hernia: What do we know? Hernia. 2010;14(1):5-15.

Ehlers AP. The female groin hernia: Isn't it time that we study this? Ann Surg. 2022;275(2):220-221.

Kulacoglu H, Kulah B, Hatipoglu S, Coskun F. Incarcerated direct inguinal hernias: A three-year series at a large volume teaching hospital. Hernia 2000;4(3):145–147.

Yang XF, Liu JL. Acute incarcerated external abdominal hernia. Ann Transl Med. 2014;2(11):110.

Losanoff JE, Richman BW, Jones JW. Parapubic hernia: A case report and review of the literature. Hernia. 2002;6(2):82-85. DOI: 10.1007/s10029-002-0060-6