RESUMO
BACKGROUND: Primary posterior perineal hernias in men are rare. We report a case of this type of hernia associated with dolichocolon, a condition which, to our knowledge, has not been reported previously. CLINICAL CASE: A 71-year old male presenting with a perineal tumour of 40 years evolution. He had no history of perineal surgery or trauma. On physical examination, a lump of 4×3cm was observed in the right para-anal region, which increased in volume during the Valsalva manoeuvre. Computed tomography showed a defect in the pelvic floor, which was reconstructed using a roll of polypropylene mesh in the hernia defect. DISCUSSION: The case described is of interest, not only because a perineal hernia is a rare clinical entity, but also because repair using a roll of mesh has not been reported associated with a dolichocolon, which can be considered a factor risk for development. CONCLUSIONS: The surgical approach and repair technique of the pelvic floor for perineal hernias should be individualised. The use of mesh for reconstruction should always be considered. The presence of dolichocolon can contribute to the gradual development of a perineal hernia.