Strangulated direct hernia loop perforation in a COVID positive patient: a case report

Abstract

A strangulated hernia occurs when the blood supply to the contents of the hernia (e.g. omentum, bowel) is compromised and may lead to bacterial translocation and intestinal wall necrosis (potentially resulting in bowel perforation). This condition significantly increases the risk of emergency hernia repair which may increase the incidence of surgical site contamination and recurrence. We report a 28-year old male who presented in the emergency with right inguinal abdominal pain for the past 5 days which increased suddenly in the last 2 days, associated with abdominal distension, constipation with 2 episodes of vomiting. During surgery, the hernia was found to be a direct one containing a strangulated perforated loop of the terminal ileum, a rather uncommon finding in a direct hernia. Resection anastomosis of the perforated segment of the bowel was performed with uneventful intraoperative and postoperative courses.