Gastric Outlet Obstruction from Stomach-Containing Groin Hernias: Case Report and a Systematic Review

Abstract

Most abdominopelvic structures can find their way to a groin hernia. However, location, and relative fixation are important for migration. Gastric outlet obstruction (GOO) from a stomach-containing groin hernia (SCOGH) is exceedingly rare. In the current report, we present a 77-year-old man who presented with GOO from SCOGH to our facility. We performed a review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) of patients presenting with SCOGH since it was first reported in 1802. Ninety-one cases of SCOGH were identified (85 inguinal and six femoral) over the last two centuries (1802-2023). GOO from SCOGH occurred in 48% of patients in one review and 18% in our systematic analysis. Initial presentation ranged from a completely asymptomatic patient to peritonitis. Management varied from entirely conservative treatment to elective hernia repair to emergent laparotomy. Only one case of laparoscopic management was documented. Twenty-one deaths from SCOGH were reported, with most occurring in early manuscripts (1802-1896 [n = 9] and 1910-1997 [n = 10]). In the recent medical era, outcomes for patients with this rare clinical presentation are satisfactory and treatment ranging from conservative, non-operative management to surgical repair should be tailored towards patients' clinical presentation.

Keywords: femoral hernia; gastric inguinal hernia; gastric obstruction; groin hernia; inguinal hernia; sliding hernia.

Figure 1

(A), Sagittal computed tomography image of the abdomen depicting the stomach extending into the left groin causing gastric outlet obstruction. (B), Coronal radiograph of the abdomen depicting the tip of the nasogastric tube in the left groin (arrow).

Figure 2

PRISMA flow-chart describing the process of our literature search. * Total number of patients includes our present case.