Abstract
BackgroundAn inguinal hernia is a common disease; however, a malignant tumor within the inguinal hernia sac is rare, and perforated colon cancer in the hernia sac is extremely rare.Case presentationA 73-year-old man presented to our hospital with high fever and painful bulging of the lower abdomen. Computed tomography showed air-containing fluid in the abdominal wall, as well as localized wall thickness of the sigmoid colon in the left groin. An emergency operation revealed a huge subcutaneous abscess and a hard mass of the sigmoid colon within an indirect inguinal hernia sac. Sigmoidectomy and hernia repair using the Marcy method were performed. Lymph node dissection was performed through a transrectal abdominal incision. Histopathological examination of the resected specimen revealed moderately differentiated adenocarcinoma invading the serosal layer with lymph node metastasis.ConclusionsIncarcerated inguinal hernia with perforated colon cancer is rare; an emergent operation should accordingly be performed based on infection control, oncological principles, and secure hernia repair.
Highlights
An inguinal hernia is a common disease; a malignant tumor within the inguinal hernia sac is rare, and perforated colon cancer in the hernia sac is extremely rare.Case presentation: A 73-year-old man presented to our hospital with high fever and painful bulging of the lower abdomen
Incarcerated inguinal hernia with perforated colon cancer is rare; an emergent operation should be performed based on infection control, oncological principles, and secure hernia repair
We present a case of incarcerated sigmoid colon cancer in an inguinal hernia sac associated with an abdominal wall abscess
Summary
An inguinal hernia is a common disease; a malignant tumor within the inguinal hernia sac is rare. We present a case of incarcerated sigmoid colon cancer in an inguinal hernia sac associated with an abdominal wall abscess. We suspected a perforated sigmoid colon cancer with abdominal wall abscess due to the incarcerated left inguinal hernia and performed an emergency operation. Operation When the left inguinal skin was incised, purulent fluid flowed from a subcutaneous abscess cavity, and a huge hernia sac was identified (Fig. 3a). With partial resection of the hernia sac adhering to the sigmoid colon was performed, and both the oral and anal colon were placed in the abdominal cavity through the hernial orifice. The abdominal wall abscess had developed due to penetration of the sigmoid cancer into the hernia sac.
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