A Case of Obstructed Ventral Hernia with Intraoperative Findings of Multiple Colonic Diverticulitis with Faecal Evisceration

Abstract

Ventral hernia refers to any protrusion of intestine or other tissue through a weakness or gap in the abdominal wall. We report a rare case of a 75 years old female presented with features of obstructed infraumbilical hernia without signs of peritonitis. USG abdomen was suggestive of infraumbilical defect with omentum and bowel loop as contents. Patient was taken for emergency open ventral hernioplasty. On exploration, surprisingly we found sigmoid diverticulitis with fecal evisceration. Although colonic diverticular disease is widely prevalent, perforated diverticulitis occurring within an obstructed hernia sac is an uncommon clinical finding, making this case particularly rare. On table decision was taken to proceed with Hartamann's procedure and primary closure of ventral hernia defect without mesh placement. This case emphasizes the need for preoperative investigations, adaptability, timely action during surgical intervention and intricate surgical strategies employed to address the unique combinations of pathologies.