Giannattasio Alessandro, Campus Riccardo, Muraca Monica, Lucigrai Giorgio, Michelazzi Alberto, Eljerbi Etayeb Mahmud, Lorini Renata, d'Annunzio Giuseppe
Department of Pediatrics, University of Genoa, Giannina Gaslini Institute, Genova, Italy;
Pediatr Rep. 2009 Jun 8;1(1):e6. doi: 10.4081/pr.2009.e6.
Acute or perforated appendicitis within inguinal hernia is rarely encountered and it is known as Amyand's hernia. We report on the first case occurring in a 4-year-old boy affected by permanent neonatal diabetes mellitus due to pancreatic agenesis, an extremely rare condition. The initial suspicion of inguinal hernia was confirmed by ultrasound examination of the right inguinal region which revealed omental layers inside a swollen inguinal canal; this finding and the clinical presentation allowed a prompt and appropriate surgical management. The careful evaluation of this patient and early recognition of this unique presentation of appendicitis allowed trans-hernial appendectomy and immediate herniorrhaphy. Ultrasonography played a pivotal role to reach the correct diagnosis and to start a prompt treatment.
腹股沟疝合并急性或穿孔性阑尾炎很少见，被称为阿米亚德疝。我们报告了首例发生在一名4岁男孩身上的病例，该男孩因胰腺发育不全患有永久性新生儿糖尿病，这是一种极其罕见的病症。对右侧腹股沟区的超声检查证实了最初对腹股沟疝的怀疑，检查发现肿胀的腹股沟管内有网膜层；这一发现和临床表现使得能够迅速进行适当的手术治疗。对该患者的仔细评估以及对阑尾炎这种独特表现的早期识别，使得能够进行经疝阑尾切除术并立即进行疝修补术。超声检查在做出正确诊断和开始及时治疗方面发挥了关键作用。
