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Inguinal hernias are common among preterm neonates, with a relatively high rate of incarceration. We report a unique case of an extremely premature neonate with an enlarging right inguinal hernia that progressed to incarceration, bowel strangulation with necrosis, and subcutaneous rupture of the hernia sac on the 21 day of life requiring urgent laparotomy for reduction and resection of the necrotic small bowel and ostomy creation. The potential morbidity of a missed incarcerated inguinal hernia is high. Neonatologists and pediatricians should consider a low threshold for early surgical referral and evaluation in all pediatric patients. Although incarcerated inguinal hernias are relatively common in preterm neonates, we believe that this is the first report of an inguinal hernia with bowel strangulation and subcutaneous rupture of the hernia sac in a preterm neonate in the literature.

Inguinal Hernia in a Preterm Neonate Complicated by Strangulation and Subcutaneous Hernia Sac Rupture