Strangulated Richter’s femoral hernia in a male patient: A rare and atypical presentation

Introduction: Richter’s hernia is an uncommon hernia in which the anti-mesenteric bowel wall becomes entrapped within a small fascial defect. Because intestinal continuity is preserved, patients may pass stool despite ongoing ischemia, often delaying diagnosis. Richter’s hernias most commonly occur in narrow anatomical openings, and are more common in females, making this presentation in a male patient particularly rare. Case Report: A 78-year-old male with dementia presented with four days of abdominal pain and poor oral intake. Imaging demonstrated small bowel obstruction due to a right groin hernia with surrounding edema. Urgent surgery identified a strangulated Richter’s femoral hernia with a 3-cm hemorrhagic, edematous anti-mesenteric bowel segment requiring resection and anastomosis. McVay tissue repair was performed. The patient recovered well and was discharged on postoperative day five. Conclusion: This case highlights the importance of maintaining a high index of suspicion for Richter’s femoral hernia in patients with unexplained groin pain to prevent ischemia, necrosis, and associated morbidity.