Richter Paraumbilical Hernia Managed by Invagination: A Case Report and Review of Literature

Abstract

Background: Richter hernia is a peculiar type of enterocele, which may progress to fatal bowel perforation unless early intervention is made. It used to occur at femoral ring but occurrence at ventral hernia is extremely rare. Case presentation: We report a 60-year-old female patient with tender paraumbilical hernia with absolute constipation and vomiting. On examination the patient had a low-grade fever, while the swelling was tense, tender with no impulse on cough. Plain radiograph abdomen erect position was done revealing multiple air fluid level. Repair was done after invagination of the ischemic part of the bowel loop. Conclusion: ventral hernia may be of a Richter type. Management of ischemic loop in Richter hernia does not necessitate resection and anastomosis, as invagination only is enough. Repair of the defect is mandatory while mesh placement is conditional.