Strangulated external hernia associated with generalized peritonitis

Abstract

Abstract Thirteen patients are described in whom strangulated external hernia was associated with generalized peritonitis. The causes of this combination are discussed. Although the features of peritonitis are usually quite distinguishable from those of an uncomplicated strangulated hernia, in virtually all the cases previously reported in the literature the presence of peritonitis was not recognized until operation for the hernia was undertaken. Increased awareness of this complication and a conscious effort to exclude it resulted in the correct preoperative diagnosis in 4 of our patients. When the peritonitis is recognized preoperatively it is suggested that a laparotomy should be performed to deal with the intraperitoneal lesion, and that the associated groin hernia should be repaired by a preperitoneal approach through the laparotomy incision.