A Rare Presentation of Small Bowel Obstruction Due to Obstructed Indirect Inguinal Hernia.

Abstract

Inguinal hernia is the most common hernia that affects the anterior abdominal wall. It is important to note that increased intra-abdominal pressure is a major risk factor of inguinal hernia formation. An indirect inguinal hernia in the right groin region causing small bowel obstruction is rare in elderly females. The current report illustrates the case of a 53-year-old female presenting with a history of abdominal pain (colicky) with vomiting and nausea, which required diagnostic laparoscopy plus open mesh repair of right inguinal hernia. Operative findings reveal a hernia in the right groin extended to the right labia containing fat and a segment of distal ileum that shows decreased wall enhancement with the surrounding fluid, leading to small bowel dilatation up to proximal jejunum with a maximum diameter of about five cm. This case highlights the importance of obstipation imperative to the diagnosis of small bowel obstruction due to obstructed indirect inguinal hernia.