Coughing-induced bowel transection in a patient with an incarcerated inguinal hernia: a case report
1 University of Texas Southwestern Medical Center Department of surgery, 5323 Harry Hines Blvd., Dallas, TX, 75390-9159, USA
2 VA North Texas Health Care System 4500 S., Lancaster Road, Dallas, TX, 75216, USA
Journal of Medical Case Reports 2013, 7:47 doi:10.1186/1752-1947-7-47Published: 15 February 2013
Although blunt trauma to a hernia-containing bowel is known to cause bowel perforation, this report documents the first incident of a small bowel transection following a non-traumatic event.
We report the case of a 49-year-old African American man with a chronic incarcerated inguinal hernia awaiting elective repair. He presented to the Emergency Department with abdominal pain following an episode of coughing. On examination, he was found to have peritonitis. He underwent exploratory laparotomy, and had a complete small bowel transection. A bowel resection with primary anastomosis was performed, as well an inguinal hernia repair.
Chronic hernia incarceration can lead to weakening and ischemia of the bowel, and minimal trauma can lead to perforation of the weakened segment. In such presentations, bowel resection and repair of the defect with a biological material is safe and feasible.