Management of inflamed sigmoid diverticulum inside an incarcerated right inguinal hernia: Case report of a rare discovery

INTRODUCTION: Incarcerated inguinal hernia is one of the most common emergencies in surgery. The diagnosis is usually made by physical examination, but the contents of the hernia sac may vary. CASE PRESENTATION: We present a rare case of inflamed diverticulum of the sigmoid colon found within an incarcerated right inguinal hernia sac in a 77-year-old man. The inflamed diverticulum was resected, and the hernia was repaired with synthetic mesh. No postoperative complication occurred. No previous study has reported a similar approach. DISCUSSION: It is most unusual for an uncomplicated inflamed sigmoid colon diverticulum to be found in the hernia sac when performing acute repair of an incarcerated inguinal hernia. Resection of the diverticulum and subsequent repair of the hernia with synthetic mesh is an attractive alternative. CONCLUSION: Acute diverticulitis should always be considered in patients with an acute abdomen, this includes those with a painful hernia. Emergency surgery should not be delayed, and local resection of the inflamed diverticulum may be an option if no perforation is apparent, and the surrounding colon is unaffected.