A neglected case of strangulated right groin hernia presenting with perforated ileum, vanished right testis and necrotizing fasciitis of the right groin: A case report.

INTRODUCTION AND IMPORTANCE

Hernias are one of the commonest procedures performed by general surgeons. Irreducibility, intestinal obstruction, and strangulation are common outcomes of a groin hernia when there is disregard and a delay in elective surgery. Studies have shown a considerable incidence of these hernia complications, along with the associated morbidity and death, because of delayed presentation. Testicular gangrene following incarcerated hernias is a rare entity in the adult population.

CASE PRESENTATION

Here we present a case of a 30-year-old male presented with gangrenous vanished testis, perforated ileum and necrotizing fasciitis of the right groin after a neglected strangulated right inguinal hernia.

CLINICAL DISCUSSION

Testicular infarction/gangrene is most commonly secondary to testicular torsion, an emergency that teenagers frequently experience. When it complicates inguinal hernia, it typically results in ischemia, infarction, and gangrene due to compression and impairment of the vascular supply within the inguinal canal. In cases like our where there is a necrotizing process in the groin, we feel it's appropriate to approach from the abdomen and do the resection first and proceed with the radical debridement after that.

CONCLUSION

Early diagnosis and intervention with emergency surgery are crucial for strangulated inguinal hernia and prevents unnecessary escalation of the problem with progressive infectious and necrotic destruction of adjacent tissues.