Richter's femoral hernia manifested by a progressive ileus

SummaryRichter's hernia is the protrusion and/or strangulation of part of the intestine's antimesenteric border through a rigid small defect in the abdominal wall. This hernia is difficult to diagnose because the signs and symptoms of development are innocuous. In most cases, because less than two-thirds of the circumference of the bowel wall is involved, the lumen of the intestine remains free; thus, features of intestinal obstruction are often absent. Here we report a case of strangulated Richter's femoral hernia in a 72-year-old man who had progressive ileus for 2 months. A literature review indicated that this is the longest history of ileus symptoms reported to date.