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July 1967

Strangulated Umbilical Hernia With External Fecal Fistula: Management by Delayed Definitive Surgery

Author Affiliations

Toronto, and Ira; New York
From the Department of Surgery, Beth Israel Medical Center, New York.

Arch Surg. 1967;95(1):111-114. doi:10.1001/archsurg.1967.01330130113022

UMBILICAL hernial sacs frequently contain omentum and on occasion are accompanied by transverse colon. In the rare case where a segment of colon is strangulated with resulting gangrene and there is perforation and egress of stool, previously reported and recommended methods of treatment are not applicable. The following is a report of a rather unusual complication following strangulation of transverse colon and omentum in an umbilical hernia, and its management.

Report of Case  A 62-year-old widow (126897) presented herself in the emergency room on Feb 1, 1966, with a canteloupe-sized black midabdominal mass, exuding stool from its upper left portion (Fig 1).Ten weeks earlier, after a fall, she noted the sudden appearance of a painless, irreducible umbilical mass, which slowly enlarged. In the week prior to admission she experienced occasional nausea, but at no time had vomiting, cramps, or constipation.On the morning of admission, she had slipped in