A Abo-elmagd ,Khaled Ahmed,
Richter Paraumbilical Hernia Managed by Invagination: A Case Report and Review of Literature
American Journal of Surgical Case Reports
2019
2674-5046
http://dx.doi.org/10.31487/j.AJSCR.2019.01.05
https://www.sciencerepository.org/richter-paraumbilical-hernia-managed-by-invagination_AJSCR-2019-1-105 
Abstract: Background: Richter hernia is a peculiar type of enterocele, which may progress to fatal bowel perforation
unless early intervention is made. It used to occur at femoral ring but occurrence at ventral hernia is
extremely rare.
Case presentation: We report a 60-year-old female patient with tender paraumbilical hernia with absolute
constipation and vomiting. On examination the patient had a low-grade fever, while the swelling was tense,
tender with no impulse on cough. Plain radiograph abdomen erect position was done revealing multiple air
fluid level. Repair was done after invagination of the ischemic part of the bowel loop.
Conclusion: ventral hernia may be of a Richter type. Management of ischemic loop in Richter hernia does
not necessitate resection and anastomosis, as invagination only is enough. Repair of the defect is mandatory
while mesh placement is conditional.Keywords: Richter hernia, paraumbilical hernia, invagination