Skip to main content

Advertisement

SpringerLink
Log in

Carcinoma of the sigmoid presenting as a right inguinal hernia

  • Case Report
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

We present the case of a 44-year-old man who presented with nausea, vomiting and acute pain in the right groin. On physical examination an irreducible mass was palpated in the right inguinal region. Ultrasound suggested an inguinal hernia sac with bowel contents. Subsequent right inguinal exploration revealed only unspecified necrotizing tissue, but no hernia sac or bowel contents were identified. Two days later laparotomy was required since the inguinal wound produced faecal discharge. The sigmoid appeared to be necrotic and perforated, and was subsequently resected. Histology revealed a perforated adenocarcinoma without lymph node involvement. Incarcerated inguinal hernias containing an adenocarcinoma of the colon are rare, but should be considered in patients presenting with an irreducible palpable mass in the inguinal region. Moreover, a carcinoma of the sigmoid may invade the right inguinal region. An intestinal perforation to skin-level in this population is even rarer and is associated with high morbidity and mortality rates.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. McFayden BV, Mathis CR (1994) Inguinal herniorraphy: complications and recurrences. Semin Laparosc Surg 1:128–140

    Google Scholar 

  2. Fieber S, Wolstenholme J (1955) Primary tumours in inguinal hernial sacs. Arch Surg 71:254–256

    CAS  Google Scholar 

  3. Bruce AW, Stewart AM (1958) Carcinoma of the colon occurring in an inguinal hernia. Br J Radiol 31:280–281

    Article  PubMed  CAS  Google Scholar 

  4. Lookanoff VA, Fox JI (1960) Neoplastic involvement of the colon residing in a scrotal hernia. J Mich State Med Soc 59:610–612

    PubMed  CAS  Google Scholar 

  5. Griffiths JC, Toomey WF (1964) Large bowel obstruction due to a herniated carcinoma of the colon. Br J Surg 51:715–717

    Article  PubMed  CAS  Google Scholar 

  6. Lees W (1966) Carcinoma of the colon in inguinal hernia sacs. Br J Surg 53:473–474

    Article  PubMed  CAS  Google Scholar 

  7. Silberman VA (1969) Cecal carcinoma incarcerated in an inguinal hernia. Int Surg 51:515–519

    PubMed  CAS  Google Scholar 

  8. Dross VP, Hipsley RW, Tarasidis GC (1973) Irreducible inguinal hernia due to carcinoma of the cecum. W V Med J 69:86–87

    PubMed  CAS  Google Scholar 

  9. Gross BH, Botsford JA, Colley DP (1980) Colon carcinoma in a right inguinal hernia. J Can Assoc Radiol 31:145–146

    PubMed  CAS  Google Scholar 

  10. Javors BR, Bryk D (1981) Colonic obstruction within inguinal hernia. J Can Assoc Radiol 32:162–163

    PubMed  CAS  Google Scholar 

  11. Kanzer B, Rosenberg RF (1983) Unusual contents in inguinal hernia sacs. N Y State J Med 83:1055–1056

    PubMed  CAS  Google Scholar 

  12. Sriham K, Nichols RL (1986) Colon carcinoma in inguinal hernia. IMJ Ill Med J 169:165–166

    Google Scholar 

  13. Pappas D, Romeu J, Dave PB, Subietas AS (1987) Colonic carcinoma in an inguinal hernia sac: case report and review of the literature. Mt Sinai J Med 54:162–164

    PubMed  CAS  Google Scholar 

  14. Lafferty PM (1989) Sigmoid colon carcinoma presenting within left inguinal hernias. Br J Clin Pract 43:343–344

    PubMed  CAS  Google Scholar 

  15. Knecht JW (1990) Cancer in inguinal hernias. N J Med 87:485–487

    PubMed  CAS  Google Scholar 

  16. Hale DA, Solla JA (1991) Complete colonic obstruction caused by a sigmoid colon cancer incarcerated in an inguinal hernia sac. South Med J 84:1280–1281

    Article  PubMed  CAS  Google Scholar 

  17. Tan GY, Guy RJ, Eu KW (2003) Obstructing sigmoid cancer with local invasion in an incarcerated inguinal hernia. ANZ J Surg 73:80–82

    Article  PubMed  Google Scholar 

  18. Kouraklis G, Kouskous E, Glinavou A, Raftopoulos J, Karatzas G (2003) Perforated carcinoma of the sigmoid colon in an incarcerated inguinal hernia: report of a case. Surg Today 33:707–708

    Article  PubMed  Google Scholar 

  19. Mandava N, Kumar S, Pizzi WF, Aprile J (1996) Perforated colorectal carcinomas. Am J Surg 172:236–238

    Article  PubMed  CAS  Google Scholar 

  20. Habib FA, McAleese P, Kolachalam RB (1998) Laparoscopic approach to the management of incarcerated hernia of appendices epiploicae: report of two cases and review of the literature. Surg Laparosc Endosc 8:425–428

    Article  PubMed  CAS  Google Scholar 

  21. Lyass S, Kim A, Bauer J (1997) Perforated appendicitis within an inguinal hernia: case report and review of the literature. Am J Gastroenterol 92:700–702

    PubMed  CAS  Google Scholar 

  22. Yahchouchy-Chouillard EK, Aura TR, Lopez YN, Limot O, Fingerhut AL (2002) Transverse colon diverticulitis simulating inguinal hernia strangulation: a first report. Dig Surg 19:408–409

    Article  PubMed  Google Scholar 

  23. Oruc MT, Akbulut Z, Ozozan O, Coskun F (2004) Urological findings in inguinal hernias: a case report and review of the literature. Hernia 8:76–79

    Article  PubMed  Google Scholar 

  24. Yoell JH (1959) Surprises in inguinal hernial sacs, diagnosis of tumors by microscopic examination. Calif Med 91:146–148

    PubMed  CAS  Google Scholar 

  25. Lejar J (1889) Neoplasmes herniaires et peri-herniaires. Gaz Hosp 62:801

    Google Scholar 

  26. Nicholson CP, Donohue JH, Thompson GB, Lewis JE (1992) A study of metastatic cancer found during inguinal hernia repair. Cancer 69:3008–3011

    Article  PubMed  CAS  Google Scholar 

  27. Bijnens E, Broekcx J, Hoffbauer R, Borreman JP (1992) Sonographic diagnosis of an incarcerated inguinal hernia containing uterus and left adnex. A J Ultrasound Med 11(5):249–250

    CAS  Google Scholar 

  28. Edmunds LH, Williams GM, Welch CE (1960) External fistulas arising from the gastro-intestinal tract. Ann Surg 152:445–471

    Article  PubMed  Google Scholar 

  29. Schein M, Decker GAG (1991) Postoperative external alimentary tract fistulas. Am J Surg 161:435–438

    Article  PubMed  CAS  Google Scholar 

  30. Roback SA, Nicoloff DM (1972) High output enterocutaneous fistulas of the small bowel. An analysis of fifty-five cases. Am J Surg 123:317–322

    Article  PubMed  CAS  Google Scholar 

  31. Chamberlain RS, Kaufman HL, Danforth DN (1998) Enterocutaneous fistula in cancer patients: aetiology, management, outcome, and impact on further treatment. Am Surg 64:1204–1211

    PubMed  CAS  Google Scholar 

  32. Simons MP, de Lange D, Bleets GL, van Geldere D, Heij HA, Go PMNYH (2003) Richtlijn ‘Liesbreuk’ van de Nederlandse Vereniging voor Heelkunde. Ned Tijdschr Geneeskd 147:2111–2117

    PubMed  CAS  Google Scholar 

  33. van den Berg JC, de Valois JC, Go PMNYH, Rosenbusch G (1999) Detection of groin hernia with physical examination, ultrasound, and MRI compared with laparoscopic findings. Invest Radiol 34:739–743

    Article  PubMed  Google Scholar 

  34. Lilly MC, Arregui ME (2002) Ultrasound of the inguinal floor for evaluation of hernias. Surg Endosc 16:659–662

    Article  PubMed  CAS  Google Scholar 

  35. Bradley M, Morgan D, Pentlow B, Roe A (2003) The groin hernia—an ultrasound diagnosis? Ann R Coll Surg Engl 85:178–180

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, NL-3300, AK, Dordrecht, The Netherlands

    J. L. Boormans, W. L. E. M. Hesp & P. W. Plaisier

  2. Laboratory for Pathology, Dordrecht, The Netherlands

    T. M. Teune

Authors
  1. J. L. Boormans
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W. L. E. M. Hesp
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T. M. Teune
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. W. Plaisier
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P. W. Plaisier.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Boormans, J.L., Hesp, W.L.E.M., Teune, T.M. et al. Carcinoma of the sigmoid presenting as a right inguinal hernia. Hernia 10, 93–96 (2006). https://doi.org/10.1007/s10029-005-0019-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-005-0019-5

Keywords

Search

Navigation