Strangulated Femoral Hernia with Perforated Jejunal Pseudo Diverticulum: a Case Report

Vito Ekasaputra


Introduction: Sixty percent of femoral hernias are characterized by incarceration and strangulation. Jejunal pseudo diverticulum are rare and usually asymptomatic. It may cause chronic obstruction of small bowel and can lead to an acute perforation.

Case presentation: An 85 – year – old woman presenting with 1 week history of generalized abdominal pain, with episodes of vomiting, fever, and history of 6 months of reponible femoral hernia and 2 weeks strangulated of femoral hernia. An abdominal X-ray displayed multiple dilated loops of the small bowel, coil spring sign and intra peritoneal free air. This  patient underwent a laparotomy and hernioraphy, which identified single perforated jejunal pseudo diverticulum 50 cm from ligamentum of treitz orally from strangulated of ileal on femoral hernia site, and associated fecal contamination. The management for this case was perforation repaired with diverticulectomy, simple closure, and extensive washout of intraperitoneal cavity. The non tension femoral hernia repair was performed with monofilament, macroporous MESH.

Conclusion: chronic intestinal obstruction caused by femoral hernia in the elderly can lead a performed of intestinal pseudo diverticulum and lead to significant morbidity and mortality. This could be suspected in those presenting with cramping abdominal pain and altered bowel habits.

Keywords: hernia, femoral, strangulated, pseudo diverticulum, perforated, management


hernia;femora;strangulated;pseudo diverticulum;perforated;management

Full Text:



Albert, J. G. (2012) ‘Interventional balloon-enteroscopy’, Journal of Interventional Gastroenterology, 2(1), pp. 42–50. doi: 10.4161/jig.20134.

Ejaz, S., Vikram, R. and Stroehlein, J. R. (2017) ‘Non-Meckel Small Intestine Diverticulitis’, Case Reports in Gastroenterology, 11(2), pp. 462–472. doi: 10.1159/000475747.

Harbi, H. et al. (2017) ‘Jejunal diverticulitis. Review and treatment algorithm’, Presse Medicale. Elsevier Masson SAS, 46(12P1), pp. 1139–1143. doi: 10.1016/j.lpm.2017.08.009.

Kassir, R. et al. (2015) ‘Jejuno-ileal diverticulitis: Etiopathogenicity, diagnosis and management’, International Journal of Surgery Case Reports. Elsevier Ltd, 10, pp. 151–153. doi: 10.1016/j.ijscr.2015.03.044.

Levack, M. M., Madariaga, M. L. and Kaafarani, H. M. A. (2014) ‘Non-operative successful management of a perforated small bowel diverticulum’, World Journal of Gastroenterology, 20(48), pp. 18477–18479. doi: 10.3748/wjg.v20.i48.18477.

Liu, K. T. and Wu, Y. H. (2017) ‘Spontaneous perforation of Meckel diverticulum’, Medicine (United States), 96(52), pp. 3–4. doi: 10.1097/MD.0000000000009506.

Peraneau, W. H. and S., D. (2013) Appendix, Meckel’s, and other small bowel diverticula. Maingot’s Abdominal operation. 12th edn. USA: Mc Graw Hill.

Transue, D. L. et al. (2016) ‘Small bowel diverticulitis: an imaging review of an uncommon entity’, Journal of American Society of Emergency Radiology. Emergency Radiology, 24(2), pp. 195–205. doi: 10.1007/s10140-016-1448-4.


Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM


  • There are currently no refbacks.

Copyright (c) 2018 Sains Medika: Jurnal Kedokteran dan Kesehatan

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at

stats View My Stats.