Hernia: Richter hernia: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hernia: Richter hernia

Sample item

An elderly woman has a tender, irreducible, red swelling below and lateral to the pubic tubercle. She is passing flatus and stool and has no vomiting or distension. At surgery, only the antimesenteric wall of the ileum is found gangrenous in the sac. What is this hernia?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Richter hernia

In a Richter hernia only part of the circumference of the bowel wall is trapped in the defect, most often in femoral hernias. Because the lumen stays partly patent, obstruction is absent and the diagnosis may be missed, yet the trapped wall can strangulate and perforate. Femoral hernias are the commonest site and are more frequent in women.

Option by option

  • A. Maydl hernia

    A Maydl hernia contains two loops in the sac with the intervening loop lying in the abdomen (W-shaped).

  • B. Littre hernia

    A Littre hernia contains a Meckel diverticulum.

  • C. Sliding hernia

    A sliding hernia has a viscus forming part of the sac wall, such as caecum or sigmoid colon.

  • D. Richter hernia (correct)

    Only part of the bowel wall is nipped, which explains strangulation without obstruction.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Richter hernia. In a Richter hernia only part of the circumference of the bowel wall is trapped in the defect, most often in femoral hernias.

Why is "Maydl hernia" not the answer?

A Maydl hernia contains two loops in the sac with the intervening loop lying in the abdomen (W-shaped).

Why is "Littre hernia" not the answer?

A Littre hernia contains a Meckel diverticulum.

Why is "Sliding hernia" not the answer?

A sliding hernia has a viscus forming part of the sac wall, such as caecum or sigmoid colon.

What concept does this question test?

It tests Hernia: Richter hernia in General Surgery. Because the lumen stays partly patent, obstruction is absent and the diagnosis may be missed, yet the trapped wall can strangulate and perforate. Femoral hernias are the commonest site and are more frequent in women.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hernia: Richter hernia?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.