A perforated sigmoid colon cancer within an inguinal hernia is extremely rare. This unexpected finding is usually discovered during surgery and causes an unavoidable septic evolution. Here, we describe the case of an 84-year-old man who presented with fever, abdominal distension, and a painful, enlarged, left scrotum. A CT showed a left, incarcerated, inguinal hernia containing a perforated sigmoid adenocarcinoma (which was confirmed by histopathology). The possibility of an irreducible inguinal hernia in association with perforated sigmoid colon cancer should be considered in the array of diagnoses. A pre-operative CT scan would be helpful in facilitating an accurate diagnosis.
Adenocarcinoma/complications/*radiography/surgery ; Aged, 80 and over ; Colon, Sigmoid/radiography/surgery ; Diagnosis, Differential ; Fatal Outcome ; Fever/etiology ; Hernia, Inguinal/complications/*radiography/surgery ; Humans ; Intestinal Perforation/complications/*radiography/surgery ; Male ; Pain/etiology ; Shock, Septic/complications ; Sigmoid Neoplasms/complications/*radiography/surgery ; Tomography, X-Ray Computed

Objective: To investigate the success rate and safety of percutaneous vasoseminal vesiculography with the disposable vasographic interventional therapy kit (VITK). METHODS: This study included ninety-six 19－65 (mean 43) years old male patients with infertility, hematospermia, seminal vesicle cyst, ejaculatory duct cyst, ejaculatory dysfunction, or vas deferens injury, with disease courses varying from 1 month to 7 years. With an open, multi-centered, single-group, self-controlled design and using the disposable VITK, we treated the patients by percutaneous vasoseminal vesiculography via injection of contrast medium into the vas deferens cavity under local anesthesia. RESULTS: Percutaneous vasoseminal vesiculography was successfully performed in 92 (97.87%) of the patients, which revealed abnormal seminal ducts in 51 cases (54.3%). Among the 28 infertile patients, 3 were found with bilateral and 5 with unilateral vas deferens obstruction. Vesiculitis was detected in 36 (81.8%) of the 44 hematospermia patients and bilateral vas deferens abnormality in 5 (38.5%) of the 13 patients with ejaculatory dysfunction. Transectional damage was observed in 2 patients with vas deferens injury induced by bilateral inguinal hernia repair. Three cases of seminal vesicle cyst and 4 cases of ejaculatory cyst were definitely diagnosed by vasoseminal vesiculography. CONCLUSIONS The disposable vasographic interventional therapy kit, with the advantages of simple operation and high safety, deserves a wide clinical application in vasoseminal vesiculography.
Adult ; Aged ; Contrast Media ; administration & dosage ; Cysts ; diagnostic imaging ; Ejaculatory Ducts ; diagnostic imaging ; Genital Diseases, Male ; diagnostic imaging ; Hemospermia ; diagnostic imaging ; etiology ; Hernia, Inguinal ; surgery ; Humans ; Infertility, Male ; diagnostic imaging ; Injections ; Male ; Middle Aged ; Postoperative Complications ; diagnostic imaging ; etiology ; Radiography ; methods ; Seminal Vesicles ; diagnostic imaging ; Vas Deferens ; diagnostic imaging ; injuries ; Young Adult