This rare hernia usually presents with both diagnostic and therapeutic dilemmas. We present the case of a 71yearold male with a threeday history of a nontender inguinal mass. Int j surg case rep 5 for commercial reuse, please contact journals. High index of suspicion by virtue of awareness of this condition can enable the surgeon to make a presumptive preoperative diagnosis. The surgeon should feel free to choose the surgical approach. The presentation of an incarcerated appendix within a femoral hernia accounts for. A computed tomography ct scan of the area showed a. This type of hernia usually presents with therapeutic dilemmas, especially because of the risk of surgical site infection ssi. In the literature, there are mostly singlecase reports. Mar 26, 2020 it is a rare phenomenon, with only 1% of all femoral hernias containing the appendix and. The appendix being present within a femoral hernia is an unusual incidental finding at surgery, occurring in 0. Majority of such cases are diagnosed intra operatively. Dictionary collections challenges community contribute.
Appendicitis occurring in this rare clinical setting represents a challenge in diagnosis and management. It is a rare phenomenon, with only 1% of all femoral hernias containing the appendix and usually found incidentally at surgery, and only 0. The appendix was seen to disappear into the hernia sac. If you have any questions, or need the bot to ignore the links, or the page altogether, please visit this simple faq for additional information. The incidence of such hernias is low and their preoperative diagnosis is challenging. Moreover, acute appendicitis inside the sac is found in 0. It is often difficult to diagnose this condition preoperatively. We present the case of a 59yearold female who presented with migratory right lower. Giant leftsided inguinoscrotal hernia containing the cecum and appendix giant leftsided amyands hernia. This eponym may be used to describe the incarceration of the vermiform appendix within a femoral hernia. We report the case of a 66yearold caucasian woman who presented with acute appendicitis within an incarcerated femoral hernia. The garehgeot sac contained a gangrenous appendix, which was excised and the hernia was repaired with sutures without complication. This anatomical phenomenon is thought to occur in as few as 0.
Intraoperatively the distal 23rd of the appendix was located within the femoral sac with features of acute gangrenous appendicitis, which was subsequently confirmed on surgical pathology. Risk factors include a long pelvic appendix, abnormal embryological bowel rotation, and a large mobile caecum. Abstract femoral hernias occur in about 3% of all abdominal wall hernias. An 85yearold caucasian female presented to the hospital with threeday history of tender and erythematous inguinal mass. Apr 12, 2007 instant access to the full article pdf. Both authors, however, describe the predestination of postmenopausal. Carey finds an incidence of 1% 10 among his relatively small patient cohort. Two case reports with correct preoperative identification of the vermiform appendix in the hernia. The presentation of an incarcerated appendix within a femoral hernia accounts for 0. This unique surgical finding is most often found intraoperatively due to the similarities it shares with an irreducible inguinal or femoral hernia that.
It is not to be confused with amyand hernia, which is an appendixcontaining inguinal hernia. Jan 23, 2019 read the original article in full on fresearch. This unique surgical finding is most often found intraoperatively due to the similarities it shares with an irreducible inguinal or femoral hernia that requires emergent surgical. When facing a patient with incarcerated hernia, emergency surgery must be indicated. Epidemiology it is a rare phenomenon, with only 1% of all femoral hernias contain. Computed tomography scan showed that the appendix was within the femoral hernia fig. Even rarer is the presence of appendicitis within the hernia sac. Salemis ns, nisotakis k, nazos k, stavrinou p, tsohataridis e 2006 perforated appendix and periappendicular abscess within an inguinal hernia. Degarengeot hernia, collected a total of 233 such cases, but added that some of them showed signs of acute appendicitis, although the cecal appendix was in the right femoral hernia 7. This hernia has higher risk of incarceration and strangulation 520% because of its narrow and rigid ring. In earlier reports operative treatment invariably involves simultaneous. This unique surgical finding is most often found intraoperatively due to the similarities it shares with an irreducible inguinal or femoral hernia that requires emergent surgical intervention. Appropriate management without incurring any delay for radiological imaging can be promising for an. The patient went home on day one after the operation.