Gastric Outlet Obstruction Secondary to Recurrent Giant Inguino-Scrotal Hernia Containing Greater Curvature of Stomach

A 79- year-old male presented to the emergency department with multiple episodes of coffee ground vomiting, anorexia and intermittent upper abdominal pain. The patient proceeded to have an urgent OGD. The test was limited in extent, as the pylorus could not be visualised due to retained gastric contents suggestive of distal gastric outlet obstruction. Subsequent, computer tomography confirmed this with a massively distended stomach extending all the way down to a point of obstruction within a left inguinal hernia. No evidence of small bowel obstruction was present on the CT scan. The patient underwent a midline laparotomy, reduction of the left inguino-scrotal hernia. The stomach was viable once reduced and so a simple pre-peritoneal mesh repair with a “Perfix Plug” was performed. Six weeks post discharge the patient re-presented with new onset of obstructive symptoms secondary to a recurrent incarcerated giant left inguino-scrotal hernia. Further diagnostic examination revealed once again a pre-pyloric obstruction of the stomach within the hernia along with multiple loops of small bowel. The patient underwent an open recurrent left-sided inguinal hernia repair with a standard Lichtenstein technique, using a “Prolene” mesh via a groin crease incision and a left orchidectomy

Citation

Kulikova, V., Scroggie, D., Glancy, D., & Peacock, M. (2020). Gastric outlet obstruction secondary to recurrent giant inguino-scrotal hernia containing greater curvature of stomach. British Journal of Surgery, 107(S3). https://doi.org/10.1002/bjs.11642

URI

https://hdl.handle.net/20.500.14709/1096