Abstract

In surgical practice inguinal hernias are a common patient presentation. Though access to surgical intervention for inguinal hernia is readily available in hospitals, lack of awareness and patient negligence leads to not seeking prompt treatment until severe symptoms appear. This is a description of a case of a 70-year-old man with long standing inguinal hernia since the past 10 years with no history of previous clinical management. The patient presented with an entero-scrotal fistula which occurred spontaneously and sought medical opinion after 6 months of developing it, when repeated faecal discharge began. This is a rare complication of underlying inguinoscrotal swelling which has been long-standing in nature. An exploratory laparotomy was performed on this patient with resection of the perforated small bowel. Purse-string suture was taken at the deep inguinal ring and end-to-end anastomosis of the ileal segment was done. There were no post-operative complications and the patient recovered without any significant impedance. Keywords: long-standing direct inguinal hernia; entero-scrotal fistula; delayed presentation;