Necrotizing inflammation of the vulva--a symptom of Richter intestinal wall hernia

Parietal hernias, often also known as Littre's hernia and Richter's hernia, are a special kind of inguinal hernias. In this type of hernia, part of the abdominal (intestinal) wall is strangulated in "calotte form" in the hernial orifice; as a result, parietal hernias often cause only mild complaints and are surgically treated only in the late stage of enterocutaneous faecal fistula. In contrast to incarcerated inguinal hernias resulting in diffuse faecal peritonitis via infarction and necrosis, parietal hernia of the Richter type is locally restricted in extension because of the narrow hernial orifice, as far as the extension into the abdominal cavity is concerned; intestinal patency is usually maintained. The possibility of the existence of a perforated parietal hernia should always be considered in necrotising inflammations in the inguinal and vulvar regions, even if abdominal signs and symptoms are absent.