Spontaneous Entero-Cutaneous Fistula due to Femoral Hernia: A Case Report

TL;DR

An elderly woman developed a rare and dangerous intestinal fistula from a femoral hernia, requiring emergency surgery for recovery.

Contribution

Reports a rare case of spontaneous enterocutaneous fistula due to femoral hernia and emphasizes the importance of early diagnosis and surgery.

Findings

Enterocutaneous fistula from a femoral hernia is rare but life-threatening.

Emergency surgery resolved the fistula and hernia successfully in an elderly patient.

Early imaging and intervention are critical to prevent complications.

Abstract

An enterocutaneous fistula is an aberrant connection between the intra-abdominal gastrointestinal tract and skin/wound. Spontaneous enterocutaneous fistula secondary to femoral hernia is extremely rare but may be life-threatening because of sepsis, malnutrition and stuid-electrolyte imbalance. We report an 83-year-old woman who presented with a short history of irreducible right groin swelling associated with feculent discharge. Contrast-enhanced computed tomography revealed a perforated distal ileal loop within a right femoral hernia, forming an enterocutaneous fistula. She underwent emergency laparotomy, segmental ileal resection with Meckel’s diverticulectomy, primary ileo-ileal anastomosis and hernia repair without mesh. Her postoperative recovery was uneventful and she remains well on follow-up. This case highlights the need to consider femoral Richter’s hernia with spontaneous enterocutaneous fistula in elderly women presenting with atypical groin discharge, and supports early imaging and definitive surgery to prevent morbidity.

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