Talukder Shibojit, Gupta Ashish, Singh Basant Narayan, Kaman Lileswar, Reddy P Abhinaya
Senior Resident, Department of General Surgery, PGIMER, Chandigarh, India.
Senior Medical Officer, Department of Hospital Administration, PGIMER, Chandigarh, India.
J Clin Diagn Res. 2017 Jul;11(7):PD05-PD07. doi: 10.7860/JCDR/2017/28201.10195. Epub 2017 Jul 1.
Strangulation of groin hernia can result in significant morbidity and mortality. Spontaneous external fistulation following strangulation is rare and typically occurs with Richter's hernia. Spreading Necrotizing Soft Tissue Infection (NSTI) secondary to Enterocutaneous Fistula (ECF) is an ominous sign, further worsening its prognosis. Early diagnosis and prompt surgical treatment is crucial to improve outcome. Herewith the authors are presenting a case of neglected inguinal hernia. It was complicated with ECF formation and rapidly spreading NSTI of flank. He underwent resection and anastomosis of the gangrenous bowel, anatomical repair of the hernia along with soft tissue debridement of flank region. This patient however succumbed to sepsis with multi organ dysfunction. Significant delay in seeking medical care led to dismal outcome.
腹股沟疝绞窄可导致严重的发病率和死亡率。绞窄后自发性外瘘罕见，通常发生于里脱疝。肠皮肤瘘（ECF）继发的播散性坏死性软组织感染（NSTI）是一个不祥之兆，会进一步恶化其预后。早期诊断和及时的手术治疗对于改善预后至关重要。在此作者报告一例被忽视的腹股沟疝病例。该病例合并ECF形成及迅速蔓延至侧腹的NSTI。患者接受了坏死肠段的切除吻合、疝的解剖修复以及侧腹区域的软组织清创。然而，该患者因多器官功能障碍死于败血症。就医的显著延迟导致了悲惨的结局。
