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Case Reports in Surgery
Volume 2013, Article ID 890234, 4 pages
http://dx.doi.org/10.1155/2013/890234
Case Report

Strangulation and Necrosis of an Epiploic Appendage of the Sigmoid Colon in a Right Inguinal Hernia

1Department of Faculty Surgery named after Professor A.A. Rusanov, Saint Petersburg State Pediatric Medical University, Litovskaya Street 2, Saint Petersburg 194100, Russia
2Sixth Department of Surgery, Mariinsky Hospital, Saint Petersburg, Russia

Received 30 May 2013; Accepted 13 August 2013

Academic Editors: T. Çolak and C. Foroulis

Copyright © 2013 Yuri N. Shiryajev et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

An epiploic appendage of the sigmoid colon is considered to be an unusual type of inguinal hernia content. The strangulation of a sigmoid colon appendage into a right inguinal hernia is exclusively rare. We present a case of an 81-year-old female patient with severe cardiovascular comorbidities who was urgently admitted after an episode of strangulation and subsequent spontaneous reduction of a right inguinal hernia. The condition of the patient was stable, and an urgent operation was not indicated for three days after admission. However, we had to operate because the hernia strangulation recurred. In the hernia sac, a free fatty body (a separated and saponified epiploic appendage of the colon) and a strangulated epiploic appendage of dolichosigmoid, with signs of necrosis, were found. Removal of the free fatty body and necrotic epiploic appendage and subsequent anterior-wall inguinal hernioplasty were successfully performed. In the world literature, this case may be the first report of a sigmoid epiploic appendage strangulation in a right inguinal hernia that is well documented by photography.