Danushka Pg Nadun, Jayasinghe Ravindri, Dunusinghe Kamal
Department of Surgery, The National Hospital of Sri Lanka, Colombo, Sri Lanka.
SAGE Open Med Case Rep. 2023 Mar 28;11:2050313X231164490. doi: 10.1177/2050313X231164490. eCollection 2023.
Inguinal hernia is a potentially occult common surgical condition. Its association with asymptomatic adenocarcinoma is uncommon. However, malignancy-associated perforation of the large bowel within an irreducible hernia is rare. We report a case of 78-year-old male presenting with a long-standing inguinal hernia with a 2-day history of irreducibility. Examination revealed a large left-sided irreducible inguinal hernia. Patient underwent urgent inguinal herniotomy, during which multiple perforations were noted in the sigmoid colon. Patient underwent Hartmann's procedure following bowel resection. Histology revealed a mucinous adenocarcinoma with extensive metastasis involving the resection margins. Elderly patients with long-standing inguinal hernia presenting with acute symptoms should be evaluated further for this rare but sinister diagnosis.
腹股沟疝是一种潜在隐匿的常见外科疾病。它与无症状腺癌的关联并不常见。然而，不可复性疝内大肠的恶性肿瘤相关穿孔却很罕见。我们报告一例78岁男性患者，患有长期腹股沟疝，有2天不可复性病史。检查发现左侧巨大不可复性腹股沟疝。患者接受了急诊腹股沟疝修补术，术中发现乙状结肠有多处穿孔。患者在肠切除术后接受了哈特曼手术。组织学检查显示为黏液腺癌，伴有广泛转移累及手术切缘。对于出现急性症状的长期腹股沟疝老年患者，应进一步评估这种罕见但严重的诊断。
