[Perforation of the small intestine in patients with hernia].

Two cases of intestinal perforation associated with inguinal hernia or incisional hernia are presented along with a review of the literature. The great majority are men over the age of 45 with a reducible and usually right-sided inguinal hernia. When a loop of bowel lies opposite a point of weakness in the abdominal wall, such as a hernial orifice, and intraabdominal pressure suddenly rises, the resulting intraluminal pressure ruptures the bowel where it is unsupported. Perforation results in diffuse peritonitis in a few hours. The treatment consists in laparotomy, simple closure of the perforation and drainage of the abdomen. Repair of the hernia is recommended 2 months after healing of the peritonitis. If the complication is early detected and treated the outcome is good.