Abstract
We present a rare and unusual finding of black discoloration of the inguinal region in a 67-year-old married female patient. She was admitted to the Emergency Department due to pain in the lower left abdomen. A black swelling, the size of a ping-pong ball, was identified on physical examination. There was an initial notion that the swelling was, in fact, a strangulated inguinal hernia. However, within additional diagnostics, a CT scan of the abdomen was performed, verifying sigmoid colon diverticulosis, with a perforation of the diverticulum and a fistulose duct protruding into the left groin. After the evaluation was complete, a left hemicolectomy was performed, as well as the resolution of the fistulose duct and the debridement of the inguinal region. Appropriate assessment, a careful review of medical records, and laboratory diagnostics are very important parameters but are not sufficient for establishing a definitive diagnosis of colon diverticulosis unless additional radiological imaging diagnostics are also carried out.
References
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Andrabi SI, Pitale A, El-Hakeem AA (2007) Diverticular abscess presenting as a strangulated inguinal hernia: case report and review of the literature. Ulster Med J 76(2):107–108
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Tadic, B., Grubor, N., Mitrovic, M. et al. The Black Inguinum: What Is Behind It?. Indian J Surg 85, 994–995 (2023). https://doi.org/10.1007/s12262-022-03622-x
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DOI: https://doi.org/10.1007/s12262-022-03622-x