Transverse Colon Necrosis Secondary to Strangulated Right Inguinoscrotal Hernia: A Rare Surgical Emergency

¹Ettaoussi Abdelhak,²El Mkhalet Majda,³Adri Hamza,⁴Bouali Ichrak,⁵Kamal Khadija,⁶Abdessamad Majd,⁷Bouali Mounir,⁸El Bakouri Abdelillah,⁹El Hattabi Khalid

^{1,2,3,4,5,6,7,8,9}Department of Visceral Emergency P35, Faculty of Medicine and Pharmacy, Ibn Rochd University Hospital, Hassan II University, Casablanca, Morocco

DOI: 10.58806/ijhmr.2026.v5i3n13

ABSTRACT

Background: Inguinoscrotal hernias are common in elderly males. Although incarceration and strangulation are well-known complications, involvement of the transverse colon with subsequent necrosis remains uncommon and may present without classical signs of bowel obstruction.
Case Presentation: We report the case of a 71-year-old male, chronic smoker (40 pack-years), with a one-year history of a progressively enlarging right inguinoscrotal hernia. The hernia became irreducible and painful 24 hours prior to admission, without cessation of flatus or stool and without bowel transit disturbance. On examination, the patient was hemodynamically stable and afebrile. Abdominal examination revealed a painful, irreducible, non-expansile right inguinoscrotal hernia without inflammatory skin changes. Emergency surgery revealed a small amount of reactive peritoneal fluid and necrosis of the mid-transverse colon after reduction of the hernia contents. A segmental transverse colectomy with resection of necrotic greater omentum was performed, followed by a diverting transverse colostomy (Bouilly–Wolkman procedure). Hernia repair was completed using the Bassini technique. The remainder of intra-abdominal exploration was unremarkable.
Conclusion: Strangulated inguinoscrotal hernia may occur without classical obstructive symptoms. Early surgical exploration remains mandatory in irreducible painful hernias, even in the absence of bowel obstruction signs, to prevent catastrophic complications such as colonic necrosis.

KEYWORDS

Inguinoscrotal hernia, Strangulation, Transverse colon necrosis, Emergency surgery, Bassini repair

REFERENCES

1) A. Danish, « Incarcerated right inguinal hernia containing sigmoid colon: An unusual case report », Int. J. Surg. Case Rep., vol. 95, p. 107237, juin 2022, doi: 10.1016/j.ijscr.2022.107237.
2) A. Sgro, J. McIntyre, et A. Luhmann, « Mechanical small bowel obstruction secondary to acute cholecystitis in the context of an irreducible inguinal hernia: A case report », Impact Surg., vol. 2, no 5, p. 179‑180, juill. 2025, doi: 10.62463/surgery.189.
3) R. Jha, S. Shrestha, B. R. Bhatta, R. P. Upadhayay, et R. Prasad, « Straining induced spontaneous bowel transection in a patient with incarcerated inguinal hernia with cryptorchidism: A case report », Int. J. Surg. Case Rep., vol. 128, p. 111093, mars 2025, doi: 10.1016/j.ijscr.2025.111093.
4) A. Alnumay, S. Batais, A. Albalawi, N. Alzaharani, et S. H. Aldeligan, « Closed-loop bowel obstruction caused by a right inguinal hernia containing the transverse colon: an unusual case report », J. Surg. Case Rep., vol. 2025, no 2, p. rjaf081, févr. 2025, doi: 10.1093/jscr/rjaf081.
5) S. Nachimuthu et S. Gergely, « Strangulated inguinal hernia due to an omental band adhesion within the hernial sac: a case report », Cases J., vol. 2, no 1, p. 21, déc. 2009, doi: 10.1186/1757-1626-2-21.
6) F. Köckerling et M. P. Simons, « Current Concepts of Inguinal Hernia Repair », Visc. Med., vol. 34, no 2, p. 145‑150, 2018, doi: 10.1159/000487278.
7) Z. Fadoua, « Diagnostic and Surgical Considerations in Strangulated Richter’s Hernia: A Case Study », Int. J. Clin. Stud. Med. Case Rep., vol. 57, no 4, 2025, doi: 10.46998/IJCMCR.2025.57.001419.
8) J. I. Staubitz, P. Gassmann, D. W. Kauff, et H. Lang, « Surgical treatment strategies for giant inguinoscrotal hernia – a case report with review of the literature », BMC Surg., vol. 17, no 1, p. 135, déc. 2017, doi: 10.1186/s12893-017-0331-x.
9) A. M. A. Abu Sba, O. M.-H. AlSarraj, B. Y. Lafi, S. Dahlan, W. Odeh, et M. S. Albaqami, « Rare presentation of incarcerated ventral hernia containing transverse colon diverticulitis », J. Surg. Case Rep., vol. 2025, no 12, p. rjaf965, nov. 2025, doi: 10.1093/jscr/rjaf965.

Cite this article

Abdelhak, E., Majda, E. M., Hamza, A., Ichrak, B., Khadija, K., Majd, A., Mounir, B., Abdelillah, E. B., & Khalid, E. H. (2026). Transverse Colon Necrosis Secondary to Strangulated Right Inguinoscrotal Hernia: A Rare Surgical Emergency. INTERNATIONAL JOURNAL OF HEALTH & MEDICAL RESEARCH, 5(3), 253-255. https://doi.org/10.58806/ijhmr.2026.v5i3n13