A 70-year-old man with a femoral hernia presents with 6 hours of small bowel obstruction. On exploration, a Richter's hernia is found. Which description best defines a Richter's hernia?
- A Only the antimesenteric wall of the bowel is caught within the hernia sac ✓
- B Two loops of bowel are trapped within the hernia sac (W-shaped loop)
- C The Meckel's diverticulum forms the content of the hernial sac
- D A retroperitoneal hernia through the sciatic foramen
Correct answer: A. Only the antimesenteric wall of the bowel is caught within the hernia sac
Explanation
A Richter's hernia involves only the antimesenteric wall (not the full circumference) of the bowel being incarcerated in the hernia sac. This is dangerous because it can strangulate and even perforate without causing complete bowel obstruction—so the diagnosis may be missed. It most commonly occurs in femoral hernias. Option B describes a Maydl hernia (W-hernia). Option C describes a Littre's hernia (Meckel's diverticulum in the sac). Option D describes an obturator or gluteal hernia, not Richter's.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.