The Black Inguinum: What Is Behind It?

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.