Femoral Hernia Repair and Anterolateral Thigh Flap for a Patient with an Incarcerated Femoral Hernia and Inguinal Abscess

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  • Richter型大腿ヘルニア嵌頓，小腸穿孔による鼠径部膿瘍に対してヘルニア修復，小腸切除，一期的前外側大腿皮弁再建術を行った1例

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Abstract

An 81-year-old woman presented with a left inguinal abscess with the exudation of pus. She arrived at the hospital on foot. An examination revealed a low blood pressure at 79mmHg, an increased pulse rate of 128/min, elevated white blood count, elevated C-reactive protein, but with no acidosis. Abdominal CT showed an inguinal abscess with a left femoral hernia (Richter type). The patient underwent emergency surgery. The abscess and the hernia sac from the femoral ring were opened and the small intestine was perforated with an incarceration in a case of Richter's hernia. The perforated small intestine was resected through the opened inguinal ligament without contamination of the abdominal cavity, and the femoral ring and inguinal ligament were repaired. The abscess cavity was debrided, and the abscess cavity was repaired with an anterolateral thigh flap pedicled with the lateral femoral circumflex artery. The patient recovered immediately with intensive care, and was discharged 39 days after surgery. The anterolateral thigh flap with the lateral femoral circumflex artery was effective for the wide skin defect following femoral hernia repair with an inguinal abscess.

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