P-016 SMALL BOWEL PERFORATION WITHIN A GIANT INGUINOSCROTAL HERNIA DUE TO AN INGESTED FOREIGN BODY

Abstract Introduction Bowel perforation due to an ingested foreign body is a rare event. Its presentation within inguinoscrotal hernia, even more uncommon. Case Description We report the case of 69-year-old indigent man with chronic alcoholic liver disease history, who presented in emergency department sepsis. He was complaining nausea, vomiting and mild abdominal pain. Clinical examination revealed painful, giant right cutaneous trophic changes subcutaneous emphysema. Blood test showed leukocytosis lactic acidosis. CT scan small bowel peritonitis inside hernia sac. The patient underwent surgery. Two 5-centimeters long fishbones were found. Ileocecal resection ileocolic side-to-side anastomosis Lichtenstein hernioplasty open repair performed. A polypropylene mesh placed. Discussion Accidental ingestion followed by gastrointestinal tract cause peritonitis. There are few reports about this event happening hernia. Perforation common at points physiological angulation or narrowing passage digestive tract, such as lower esophageal sphincter, pylorus ileocecal valve. Inguinoscrotal hernias present pathologic stenotic area where bodies can produce obstruction perforation. In these cases, challenging contaminated scenario. Conclusion diagnosis inguinal should be suspected cases acute abdomen incarcerated order choose best surgical treatment option.