Gangrene of the Colon Ascendens, Colon Transversum, and Lienal Flexure in a Massive Strangulated Umbilical Hernia

This case describes an 80-year-old obese woman who presented with a giant, incarcerated umbilical hernia. The hernia was present for over 15 years, continuously increasing in size. The only symptom was the pain which lasted about two hours before arrival at the hospital. In an emergency laparotomy, gangrenous colon ascendens, transversum, and lienal flexure have been found. A subtotal colectomy with the creation of terminal ileostomy without hernia repair has been done. The recovery was uneventful, and the patient was discharged on the fifth postoperative day. After one month, the reconstruction of the digestive continuity with an L-L ileo-descendo anastomosis followed. The patient decided against the hernia repair.