Piperos Theodoros, Kalles Vasileios, Al Ahwal Yousef, Konstantinou Evangelos, Skarpas George, Mariolis-Sapsakos Theodoros
Anatomy Lab, University of Athens, School of Nursery, Athens,Greece.
Int J Surg Case Rep. 2012;3(3):116-7. doi: 10.1016/j.ijscr.2011.12.003. Epub 2011 Dec 21.
The presence of the appendix in a femoral hernia sac is known as de Garengeot's hernia. We report a rare case of an elderly woman with femoral hernia appendicitis and discuss the surgical pitfalls and considerations through a literature review.
An 83-year-old woman presented with fever and right lower quadrant abdominal pain. Clinical examination revealed a femoral hernia. Ultrasonography confirmed bowel was present in the hernia sac. In the operation room, an acutely inflamed appendix was recognized within the sac. The patient underwent appendectomy and hernia repair with sutures.
Acute appendicitis within a femoral hernia is rare and multiple dilemmas exist regarding its treatment. An incision below the inguinal ligament is a reasonable choice in order to access the hernia sac. A mesh should be placed in non-infectious appendectomy while herniorrhaphy is preferred in cases of appendicitis.
The presence of the vermiform appendix in a femoral hernia sac is rare but the surgeon should be aware of this clinical entity. Prompt diagnosis and appropriate surgical treatment is the key to avoid complications.
阑尾位于股疝囊内被称为德加伦若疝。我们报告一例老年女性股疝合并阑尾炎的罕见病例，并通过文献综述讨论手术中的陷阱及注意事项。
一名83岁女性因发热及右下腹疼痛就诊。临床检查发现股疝。超声检查证实疝囊内有肠管。在手术室中，发现疝囊内阑尾急性发炎。患者接受了阑尾切除术及疝修补缝合术。
股疝合并急性阑尾炎罕见，其治疗存在诸多难题。腹股沟韧带下方切口是进入疝囊的合理选择。非感染性阑尾炎行阑尾切除术时应放置补片，而阑尾炎病例则优先选择疝修补术。
阑尾位于股疝囊内虽罕见，但外科医生应了解这一临床情况。及时诊断和恰当的手术治疗是避免并发症的关键。
