OBSTRUCTIVE ACUTE ABDOMEN DUE TO LONG-STANDING INDIRECT INGUINOSCROTAL HERNIA: CASE REPORT
DOI:
https://doi.org/10.56238/levv17n58-076Keywords:
Abdominal Hernia, Inguinal Hernia, Acute Obstructive Abdomen, Preoperative PneumoperitoneumAbstract
Inguinal hernias are common conditions of the abdominal wall that may progress to severe complications, potentially resulting in acute obstructive abdomen and the need for emergency surgical intervention. Objective: To report and discuss the therapeutic approach of a case of acute obstructive abdomen secondary to a long-standing large inguinoscrotal hernia. Method: Descriptive study, in the form of a case report, based on medical record review, information provided by the attending surgeon, and patient report. Case report: A 72-year-old male patient with comorbidities was admitted with intense abdominal pain, distension, fecaloid vomiting, and absence of flatus and bowel movements. He reported a 15-year history of inguinoscrotal hernia, irreducible for 45 days. Computed tomography demonstrated a large hernia, with a Tanaka index of 0.22, ruling out loss of domain. Immediate surgical approach was chosen, without preoperative pneumoperitoneum, with herniorrhaphy using the Lichtenstein technique. The patient showed good evolution, was discharged on the fifth day, and had no recurrence during follow-up. Discussion: The case highlights the impact of delayed elective treatment, associated with a higher risk of complications. The Tanaka index was fundamental in surgical planning, allowing assessment of the risk of abdominal compartment syndrome and guiding management. The Lichtenstein technique proved safe and effective even in emergency settings, in the absence of intestinal necrosis. Conclusion: The described case highlights the importance of careful evaluation associated with the use of predictive tools to guide appropriate management. It also contributes to understanding strategies aimed at reducing postoperative complications, improving surgical practice and clinical outcomes.
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