Intestinal perforation from trauma to an inguinal hernia
R. D. Reynolds
Inguinal hernias are most feared to result in incarceration and
strangulation of intra-abdominal structures. Blunt abdominal blows have
previously been reported to cause traumatic perforation of bowel that
overlays the defect of any abdominal wall hernia. To my knowledge, this
case report is the first to show that bowel perforation may be caused by
direct trauma to an inguinal hernia that contains a loop of small bowel. It
is proposed that the force of the blow first opposes the walls of the
incoming and outgoing bowel, sealing the loop. Then, additional pressure
that is applied will raise the loop's intraluminal pressure to the point
that traumatic perforation occurs. A simple experiment on a necropsy
specimen showed that the proposed mechanism is plausible. This case points
out another risk of leaving an inguinal hernia unrepaired.
