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Query: UMLS:C0085693 (acute appendicitis)
 3,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 78-year-old lady presented with signs and symptoms of a strangulated femoral hernia. Peri-operatively she was found to have appendicitis within the hernia sac. Appendicectomy and non-mesh hernia repair were performed. Histology revealed acute inflammation and a villous adenoma of the appendix. Villous adenomas of the vermiform appendix are extremely rare tumours of the gastrointestinal tract. This is the first case combining two very rare pathologies--acute appendicitis presenting as strangulated femoral hernia and villous adenoma of the appendix. Early diagnosis and surgery are required to avoid high morbidity of perforated appendicitis within a femoral hernia. First, we discuss the diagnosis and surgical treatment of acute appendicitis within a femoral hernia. Second, the presence of an adenoma changes the aetiology of appendicitis. More importantly, changes in surgical management of acute appendicitis presenting as a strangulated femoral hernia owing to a co-existing adenoma are discussed.
Hernia 2008 Feb
PMID:First case of villous adenoma of the appendix leading to acute appendicitis presenting as strangulated femoral hernia: changes in management owing to concurrent adenoma. 1756 35

Acute appendicitis in a hernia sac occurs exceptionally. An 80-year-old male patient underwent emergency surgery for an incarcerated right inguinal hernia found to contain a gangrenous appendix. His brief improvement after an emergency herniotomy with appendectomy was followed by intestinal obstruction caused by advanced colon cancer. The unique features and individualized management of the four published types of Amyand hernia are reviewed. Rather than simply being an anatomical curiosity, Amyand hernias require individualized attention to decide how to manage both the appendix and the hernia. Clinical scrutiny, a high index of suspicion for surgical comorbidities, and a common sense approach may improve outcomes.
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PMID:Amyand hernia: what lies beneath--a proposed classification scheme to determine management. 1818 92

A case of acute appendicitis within an inguinal hernia known as Amyand's hernia, is presented. Multidetector CT investigation with multiplanar reconstruction (MPR) is an important tool to make an early and correct diagnosis avoiding complications in this very rare event.
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PMID:Amyand's hernia: inguinal hernia with acute appendicitis. 1837 69

Amyand's hernia is defined as an inguinal hernia within the hernial sac containing the appendix. It is a rare disease, reported in 1% of cases of inguinal hernia repair. The appendix can be complicated by acute appendicitis in 0.13% of cases. This disease is often very difficult to diagnose, and most of the time it can be confused with an incarcerated or strangulated inguinal hernia. Often, it requires an emergent surgical treatment. This article describes the case of a 82-year-old female who was admitted for an intestinal obstruction and a bulge in the right inguinal region. An abdominal computed tomography scan showed dilated small bowel loops with multiple air/liquid levels and one loop herniating into the right inguinal canal. The patient underwent a laparotomy that showed the presence of an acute appendicitis and a necrotized ileal loop protruding into the right inguinal canal. The patient underwent an appendectomy and small bowel resection and she was discharged on postoperative day 10. Amyand's hernia can be a challenge for the surgeon. Its treatment depends on the grade of inflammation of the appendix. In fact, it can range from the simple repair of the abdominal defect with a prosthetic mesh, to appendectomy, small bowel resection and repair of the abdominal wall defect without a mesh.
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PMID:[A rare presentation of Amyand's hernia. Case report and review of the literature]. 1842 48

Amyand hernia, named for the first person to describe an inguinal hernia containing the vermiform appendix, is an uncommon variant of an inguinal hernia. Presence of the appendix in the sac complicates the management of inguinal hernias. The appendix may be more prone to rupture when contained within a hernia sac, and herniation of an inflamed appendix into the scrotum can mimic an acute scrotum. A 50-year-old man presented with right lower quadrant abdominal pain associated with chills and anorexia. Physical examination revealed right lower quadrant tenderness and a right inguinal mass without associated skin changes. Laboratories were normal. A plain abdominal computed tomography scan for acute appendicitis showed an indirect right inguinal hernia with the appendix contained within the sac, which was incarcerated. Surgical consultation was obtained. The patient taken to the operating room, and his appendix was removed. The hernia was coincidentally repaired, and the patient was discharged soon thereafter. In cases suggestive of acute appendicitis complicating an inguinal hernia, the diagnosis of this unusual variant must be considered.
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PMID:Amyand hernia: a case of an unusual inguinal herniace. 1853 18

Few cases have been reported in the literature on acute appendicitis located in the hernial sac. Information scantiness is determined by rarity of pathology and difficulties in diagnosis. Incidence rate of the condition is 0.4-0.6% of cases. The acute appendicitis is frequently located in the sac of right inguinal hernia or femoral hernia sac. The studies of three cases are presented in the article. In 1994-2007 at The Surgical Department of Phyphia Clinical Hospital (Tbilisi, Georgia) there have been performed 1064 hernia repairs. Entrapped hernia was diagnosed in 189 patients of whom three patients (from 70 to 84 years old, of whom two male and one female)--with acute perforated appendicitis located in hernia sac. In two cases perforated appendix was within the right inguinal hernia area and in one case--gangrenous appendix was located in femoral hernia sac. All three patients were operated upon routinely as for entrapped hernias. Laparoscopic inguinal herniotomy with removal of gangrenous-perforated appendix was performed in two patients. Herniotomy and laparotomy was performed in one patient. In spite of old age and heavy concomitant diseases postoperative period passed uneventfully. The patients were discharged from the Clinic under further ambulatory observation.
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PMID:[The presense of acute appendicitis in the sac of inguinal hernia: case study]. 1856 31

Results of treatment of 2308 patients, suffering nonincarcerated hernia of abdominal wall of various localization, were analyzed. In 24 (1.1%) of them different pathologic changes of hernial sac were noted and in 17 (0.7%)--the diseases of organs, localized in hernial sac: an acute appendicitis, ileus, trauma, malignant tumor and others. The course of majority of the above-mentioned diseases was masked by incarcerated hernia signs, demanding the urgent operation performance. The operative intervention volume depended on the character of the organ pathological changes, localized in hernial sac, it was directed on the main disease elimination and on the abdominal wall defect closure.
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PMID:[Pathologic changes of hernial sac and its content]. 1868 Sep 97

Albeit very uncommon, the hernia sac may contain unusual structures such as vermiform appendix, acute appendicitis, ovary, fallopian tube and, urinary bladder. Most of the cases of hernia containing ovary and fallopian tubes were reported to be found in children and, often accompanied with other congenital anomalies of genital tract. We present the first case of sliding inguinal hernia containing right ovary and fallopian tube and a right paraovarian cyst in 80-year-old, multiparous patient without any associated genital anomaly. The hernia was repaired with plication darn, while the paraovarian cyst was excised and adnexa were preserved. It is of utmost importance to keep in mind that the hernia sac may contain almost any abdominal organ, and surgical dissection should be carried out accordingly. Pathophysiologically, the ovary might be simply pulled along with a sliding paraovarian cyst or the paraovarian cyst might be accompanying the maldescended ovary. There seems to be a need for clinical and experimental studies to further explain the mechanisms that apply to the pathogenesis of sliding inguinal hernias.
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PMID:A right sliding indirect inguinal hernia containing paraovarian cyst, fallopian tube, and ovary: a case report. 1883 35

Presented is a case of incarcerated paracaecal hernia mimicking acute appendicitis. The clinical scenario highlights the need for a high index of suspicion in the management of patients with localised peritonism even in the absence of obstructive symptoms and the presence of normal laboratory markers of inflammation. Whilst computed tomography might offer a pre-operative diagnosis, in such a low-risk patient laparoscopy offers the combined advantages of immediate diagnosis and definitive treatment of acute pathology.
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PMID:Ileal entrapment within a paracaecal hernia mimicking acute appendicitis. 1931 24

Acute appendicitis in an incarcerated inguinal hernia is termed an Amyand's hernia. This is an extremely rare condition. It is often misdiagnosed as a strangulated inguinal hernia. The clinical presentation varies, depending on the extent of inflammation in the hernia sac and the presence or absence of peritoneal contamination. We report a case of Amyand's hernia in a 2 year old boy who presented with shock. The basic principle in our management was to stick to the principles of resuscitation and stabilisation of the patient completely before surgery, which lead to a very successful outcome. Emphasis is given to the rarity of the disease and to the review of the literature.
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PMID:Amyand's hernia. 1980 55


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