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Intestinal gangrene due to mesenteric vascular occlusion masquerading as strangulated inguinal hernia.

Tiwary SK, Kumar D, Chowdhury S, Agrawal N, Basu S

Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.

Strangulated inguinal hernia may present with intestinal gangrene. However, mesenteric arterial thrombosis producing massive gangrene of the bowel as content in inguinal hernia is an entity probably not reported in the medical literature. We report a case of inguinal hernia presenting with features of strangulation, which on exploration was found to be a case of massive bowel gangrene due to superior mesenteric artery thrombosis affecting the terminal ileum, cecum, ascending colon and proximal three-fourths of the transverse colon. We think this is the first case report of superior mesenteric artery thrombosis masquerading as strangulated inguinal hernia and present it with a message that while dealing with an inguinal hernia with gangrenous bowel as the content, one should keep in mind a rare possibility of mesenteric thrombo-embolism as the cause.

Published 3 April 2008 in Hernia, 12(2): 195-7.
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