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NIGER DELTA JOURNAL OF MEDICINE & MEDICAL RESEARCH

A Publication Of Nigeria Medical Association Bayelsa State Branch

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Archive | ISSUE: , Volume: Jul-Sep-2025

RICHTER’S HERNIA COMPLICATED BY SPONTANEOUS ENTEROCUTANEOUS FISTULA IN NIGERIA: A CASE REPORT AND LITERATURE REVIEW


Author:Ogba ME, Ifeh MO

published date:2025-Jul-09

FULL TEXT in - | page 109 – 112

Abstract

Background: Richter’s hernia is a rare surgical condition characterised by partial entrapment of the antimesenteric bowel wall within a fascial defect. The absence of intestinal obstructive symptoms often results in delayed diagnosis and complications like bowel necrosis, enterocutaneous fistula (ECF), or Fournier’s gangrene.

Case Presentation: A 46-year-old male in rural Nigeria with a 9-year history of untreated right inguinal swelling presented with a 2-day history of faeculent discharge from the groin. Examination revealed a necrotic, irreducible groin mass with an active ECF. Imaging confirmed bowel involvement and emergency surgery identified a necrotic ileal segment secondary to Richter’s hernia. The affected bowel was resected, and primary anastomosis was performed. The patient recovered without complications.

Conclusion: This case highlights the insidious nature of Richter’s hernia and its potential for catastrophic complications like ECF, particularly in neglected hernias in low-resource settings such as Nigeria. Early surgical intervention is critical to prevent morbidity and mortality. The report underscores the need for increased clinical vigilance, improved access to elective hernia repair, and public health efforts to address barriers to surgical care in similar settings.

Keywords: Richter’s hernia, Enterocutaneous fistula, Bowel necrosis, Inguinal hernia, Surgical emergency.

Cite this article: Ogba ME, Ifeh MO. Richter’s hernia complicated by spontaneous enterocutaneous fistula in Nigeria: a case report and literature review. Niger Delta J Med Med Res. 2024;3(3):109–112.

Keywords: Richter’s hernia, Enterocutaneous fistula, Bowel necrosis, Inguinal hernia, Surgical emergency.

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