Richter's hernia - Misplaced Pages

Disease of the human digestive system

A Richter's hernia occurs when the antimesenteric wall of the intestine protrudes through a defect in the abdominal wall. This is distinct from other types of abdominal hernias in that only one intestinal wall protrudes through the defect, such that the lumen of the intestine is incompletely contained in the defect, while the rest remains in the peritoneal cavity. If such a herniation becomes necrotic and is subsequently reduced during hernia repair, perforation and peritonitis may result. A Richter's hernia can result in strangulation and necrosis in the absence of intestinal obstruction. It is a relatively rare but dangerous type of hernia.

Richter's hernia have also been noted in laparoscopic port-sites, usually when the fascia is not closed for ports larger than 10mm. A high index of suspicion is required in the post operative period as this sinister problem can closely mimic more benign complications like port-site haematomas.

Treatment is resection and anastomosis. Mortality increases with delay in surgical intervention.

References

Crabtree, TD. "General Surgery." Board Review Series, LWW&W, 2000, pp220
Rammohan A, RM Naidu.Laparoscopic port site Richter's hernia – An important lesson learnt. Int J Surg Case Rep 2011, Volume 2, Issue 1, Pages 9-11.
Rammohan, Ashwin; Naidu, R. M. (1 January 2011). "Laparoscopic port site Richter's hernia – An important lesson learnt". International Journal of Surgery Case Reports. 2 (1): 9–11. doi:10.1016/j.ijscr.2010.11.002. PMC 3199732. PMID 22096675.

Diseases of the human digestive system

Upper GI tract

Esophagus

Stomach

Lower GI tract
Enteropathy

Small intestine (Duodenum/Jejunum/Ileum)	Enteritis Duodenitis Jejunitis Ileitis Peptic (duodenal) ulcer Curling's ulcer Malabsorption: Coeliac Tropical sprue Blind loop syndrome Small intestinal bacterial overgrowth Whipple's Short bowel syndrome Steatorrhea Milroy disease Bile acid malabsorption
Large intestine (Appendix/Colon)	Appendicitis Colitis Pseudomembranous Ulcerative Ischemic Microscopic Collagenous Lymphocytic Dysentery Functional colonic disease IBS Intestinal pseudoobstruction / Ogilvie syndrome Megacolon / Toxic megacolon Diverticulitis/Diverticulosis/SCAD
Large and/or small	Enterocolitis Necrotizing Gastroenterocolitis IBD Crohn's disease Vascular: Abdominal angina Mesenteric ischemia Angiodysplasia Bowel obstruction: Ileus Intussusception Volvulus Fecal impaction Constipation Functional Diarrhea Infectious Intestinal adhesions
Rectum	Proctitis Radiation proctitis Proctalgia fugax Rectal prolapse Anismus Solitary rectal ulcer syndrome Rectal stricture
Anal canal	Anal fissure/Anal fistula Anal abscess Hemorrhoid Anal dysplasia Pruritus ani Anal stricture

GI bleeding

Accessory

Liver	Hepatitis Viral hepatitis Autoimmune hepatitis Alcoholic hepatitis Cirrhosis PBC Fatty liver MASLD Vascular Budd–Chiari syndrome Hepatic veno-occlusive disease Portal hypertension Nutmeg liver Alcoholic liver disease Liver failure Hepatic encephalopathy Acute liver failure Liver abscess Pyogenic Amoebic Hepatorenal syndrome Peliosis hepatis Metabolic disorders Wilson's disease Hemochromatosis
Gallbladder	Cholecystitis Gallstone / Cholelithiasis Cholesterolosis Adenomyomatosis Postcholecystectomy syndrome Porcelain gallbladder
Bile duct/ Other biliary tree	Cholangitis Primary sclerosing cholangitis Secondary sclerosing cholangitis Ascending Cholestasis/Mirizzi's syndrome Biliary fistula Haemobilia Common bile duct Choledocholithiasis Biliary dyskinesia Sphincter of Oddi dysfunction
Pancreatic	Pancreatitis Acute Chronic Hereditary Pancreatic abscess Pancreatic pseudocyst Exocrine pancreatic insufficiency Pancreatic fistula

Other

Hernia

Lumbar
- Petit's
- Grynfeltt–Lesshaft

Undefined location

Peritoneal

Category:

Hernias