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A D V E R T I S E M E N T
A D V E R T I S E M E N T
The sigmoid colon varies in length from individual to individual and may have a long or short mesentery.
A D V E R T I S E M E N T
The path of the incarcerated sigmoid in this case is shown. The patient was taken directly to the operating room after appropriate fluid resuscitation.
Notes:
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A D V E R T I S E M E N T
This hernia was approached from below (see femoral hernia anatomy and repair, femoral hernia case study, large femoral hernia, and infrainguinal femoral hernia repair.) The sigmoid was viable. To widen the fascial ring and free the colon, the lacunar (black dashes) or inguinal ligament (yellow dash) can be cut safely in most cases. The caveat is the presence of an aberrant obturator artery running around the rim of the upper end of the femoral canal in 1/4 to 1/3 of individuals. Isolating the ligament with a right-angle clamp protects the vessel. The inguinal ligament was cut in this case. A mesh plug was placed in the femoral canal, and the inguinal ligament and iliopubic tract were approximated to pectineus fascia.
Surgeon: Philip Perdue
Surgical Chief Resident: Carlos RodriguezNotes:
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This page was last modified on 8/2/2004.
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