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RICHTER'S HERNIA: A DECEPTIVE CLINICAL ENTITY PRESENTING AS INTESTINAL OBSTRUCTION.

Introduction: Richter's hernia is a rare entity representing a small percentage of all hernia cases. These are small fascial
defects that entrap partial circumference of the bowel and vary in presentation with associated increases in morbidity and
mortality.
Case Report: A 78-year male presented with Richter's hernia of the umbilical region which was diagnosed intra-operatively. The content was the
ileal wall with pre-gangrenous changes. Because of doubtful viability resection of the segment and end-to-end anastomosis was done. The postoperative period was uneventful.
Discussion: In female and old age patients, Richter's hernia is common with the femoral and inguinal regions being the common sites. The
presentation may vary from vague pain abdomen and swelling to gangrene and perforation peritonitis. Some patients present as intestinal
obstruction while in some cases the presentation mimics acute gastroenteritis. Radiological investigations like X-ray, ultrasonography (USG),
and CT (computed tomography) scan aid in diagnosis but most of the time diagnosis is made intraoperatively. Surgical reduction or resection is
often warranted depending on the viability of entrapped segment.
Conclusion: To diagnose and manage this deceptive clinical entity experience and expertise is required. Timely taken decision and intervention
helps to reduce morbidity and mortality associated with it