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Selective Mucosal Infarction of Small Bowel in Incarcerated Hernia

Jack R. Ludwick, MD; Errikos Constant, MD; Timothy S. Harrison, MD
Arch Surg. 1967;94(6):871-875. doi:10.1001/archsurg.1967.01330120125024.
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IN THE course of reduction and repair of an incarcerated hernia the viability of involved intestine is assessed by well-known criteria.1 On rare occasions, even after these criteria have been met, abnormalities may develop in the freed intestine. These usually take the form of localized areas of stricture in the previously incarcerated intestine. This is presumably due to an incompletely necrotizing degree of ischemia suffered by the incarcerated intestine. Several cases have been reported documenting small localized intestinal strictures under these circumstances.1-11 The following case is of added interest because of extensive, persistent mucosal loss of almost the entire ileum and an associated intractable diarrhea of severe proportions.

Report of Case  A 68-year-old white man, awoke at 6 am on Dec 16, 1965, with severe crampy lower abdominal pain, nausea and vomiting. Associated with this was the sudden enlargement of a preexisting right groin hernia. There had been


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