Why can a Richter's hernia produce strangulation and gangrene without causing complete intestinal obstruction?
- A The hernial neck is too wide to obstruct the lumen
- B The omentum within the sac decompresses the bowel proximally
- C Only part of the circumference of the bowel wall is trapped in the ring ✓
- D Richter's hernia involves only the mesentery and never the bowel wall
Correct answer: C. Only part of the circumference of the bowel wall is trapped in the ring
Explanation
In a Richter's hernia only the anti-mesenteric border, part of the circumference of the gut wall, protrudes through a narrow defect, typically a femoral ring. Because the lumen remains largely patent, gas and faeces can still pass, so classical colicky pain, distension, and absolute constipation of obstruction are absent. This deceptive presentation delays diagnosis while the thin trapped anti-mesenteric strip rapidly becomes ischaemic and gangrenous, which is precisely what makes Richter's hernia dangerous.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.