Sabra Hassan, Alimoradi Mersad, El-Helou Etienne, Azaki Rawan, Khairallah Maysaloun, Kfoury Tony
Mount Lebanon Hospital, Department of General Surgery, Mount Lebanon, Lebanon; Lebanese University, Faculty of Medical Sciences, Department of General Surgery, Mount Lebanon, Lebanon.
Mount Lebanon Hospital, Department of General Surgery, Mount Lebanon, Lebanon.
Int J Surg Case Rep. 2020;72:108-111. doi: 10.1016/j.ijscr.2020.05.067. Epub 2020 Jun 6.
Inguinal hernias are common among the population and usually contain part of the omentum or small bowel, however, other unusual contents have been reported. We report a case of a patient who presented for an incarcerated left inguinal hernia and was found to have an underlying perforated sigmoid cancer.
An 87 years old man presented with typical signs of an incarcerated left inguinal area. During surgery, we dissected free a herniated hard inflammatory mass until it was found to be covering an underlying perforated sigmoid tumor. Inguinal hernia is a common condition affecting many individuals, and colorectal cancer is one of the rare contents reported inside these hernias. Due to the rarity of such a presentation, the surprise encounter during groin surgery may lead to suboptimal treatment. Perforated colorectal cancer, like in our case, may signify a more aggressive disease, and hence a correct diagnosis is crucial to improve outcomes. When underlying colon cancer is suspected during hernia surgeries, proper exploration and oncologic resection might be the optimal choice.
Surgeons should keep the possibility of underlying colorectal cancer in mind when operating on inguinal hernias and opt for oncologic resection of the identified tumor along with proper lymph node dissection.
腹股沟疝在人群中很常见，通常包含部分大网膜或小肠，然而，也有其他不寻常内容物的报道。我们报告一例患者，因左侧嵌顿性腹股沟疝就诊，结果发现其患有潜在的乙状结肠穿孔癌。
一名87岁男性表现出左侧腹股沟区嵌顿的典型体征。手术过程中，我们游离出一个突出的坚硬炎性肿块，直至发现它覆盖着一个潜在的乙状结肠穿孔肿瘤。腹股沟疝是一种影响许多人的常见疾病，而结直肠癌是这些疝内报道的罕见内容物之一。由于这种表现罕见，腹股沟手术中的意外发现可能导致治疗效果不佳。像我们病例中的乙状结肠穿孔癌可能意味着疾病更具侵袭性，因此正确诊断对于改善预后至关重要。在疝手术中怀疑有潜在结肠癌时，适当的探查和肿瘤切除可能是最佳选择。
外科医生在进行腹股沟疝手术时应考虑到潜在结直肠癌的可能性，并选择对已识别肿瘤进行肿瘤切除以及适当的淋巴结清扫。
