Mizuno Hironori, Nagai Hidemasa, Maeda Shingo, Miyake Hideo, Yoshioka Yuichiro, Yuasa Norihiro
Department of Gastrointestinal Surgery, Japanese Red Cross Nagoya First Hospital, Nagoya, 453-8511, Japan.
Department of Surgery, Japanese Red Cross Nagoya First Hospital, Nagoya, 453-8511, Japan.
Surg Case Rep. 2019 Dec 5;5(1):189. doi: 10.1186/s40792-019-0742-2.
An 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.
A 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.
Incarcerated 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.
腹股沟疝是一种常见疾病；然而，腹股沟疝囊内的恶性肿瘤罕见，疝囊内的穿孔结肠癌极为罕见。
一名73岁男性因高热和下腹部疼痛性隆起入住我院。计算机断层扫描显示腹壁有含气液体，以及左腹股沟乙状结肠局部肠壁增厚。急诊手术发现一个巨大的皮下脓肿和一个位于间接腹股沟疝囊内的乙状结肠硬块。实施了乙状结肠切除术并采用马尔西法进行疝修补。通过经直肠腹部切口进行淋巴结清扫。切除标本的组织病理学检查显示为中分化腺癌，侵犯浆膜层并伴有淋巴结转移。
嵌顿性腹股沟疝合并穿孔结肠癌罕见；因此，应基于感染控制、肿瘤学原则和可靠的疝修补进行急诊手术。
