Case report and review of literature: Richter hernia in an anterior sacral foramen

An external hernia is an abnormal protrusion of intraabdominal tissue or the whole or part of a viscus through an opening or fascial defect in the abdominal wall (Deveney, 1985); where a portion of the bowel circumference protrudes into the hernial sac it is termed a Richter hernia. Most commonly, the antimesenteric border of the distal ileum protrudes into the femoral or inguinal rings (Frankau, 1931), presenting as intestinal obstruction (50%), perforation (35%), or perforation leading to an intestinal cutaneous fistula (15%) (Gillespie et al., 1956). One case has been reported of a Richter hernia in an anterior sacral foramen (Botsford, 1977). This is the second such report but, after perforation, the route taken by the intestinal contents through the gluteal region, resulting in cellulitis of the anterolateral aspect of the right thigh, is unique.