# Rare case of strangulated primary acquired perineal hernia causing small bowel obstruction requiring emergency operative repair

## TL;DR

A 74-year-old woman had a rare case of a strangulated perineal hernia causing bowel obstruction, requiring emergency surgery.

## Contribution

This is the first reported case of primary acquired perineal hernia causing intestinal obstruction without prior pelvic surgery.

## Key findings

- The patient presented with small bowel obstruction due to a strangulated perineal hernia.
- The hernia was repaired using a combined transabdominal and transperineal approach.
- This case expands the understanding of primary acquired perineal hernias and their management.

## Abstract

Primary acquired perineal hernia is rare with only 100 reported cases in the literature. Emergency presentations of intestinal obstruction secondary to perineal hernia are very rare and to-date, there are only eight cases reported in the literature. We present a case of a 74-year-old lady who presented with a small bowel obstruction secondary to strangulated perineal hernia in the absence of pelvic exenteration or abdominoperineal resection requiring operative repair via combined open transabdominal and transperineal approach. To our knowledge, this case represents the first reported case of intestinal obstruction secondary to primary acquired perineal hernia in the absence of pelvic exenteration or abdominoperineal resection.