Schäfer Hannah Maria, von Holzen Urs, Nebiker Christian
Department of General Surgery, University Hospital Basel, Switzerland.
Department of General Surgery, University Hospital Basel, Switzerland.
Int J Surg Case Rep. 2014;5(12):1120-2. doi: 10.1016/j.ijscr.2014.11.010. Epub 2014 Nov 11.
Femoral hernias may - in some rare cases - contain the appendix, a phenomenon called de Garengeot hernia. It is usually an incidental finding in hernia repair. We found our case to be of interest because of the long standing femoral swelling before peracute appendicitis led to its removal.
We present the case of a 71-year-old woman with a swelling of the right medial thigh for over more than 30 years. When the swelling suddenly grew in size and became tender, she was referred to our emergency department. Sonographically as well as clinically a femoral hernia was diagnosed. Intraoperatively, the appendix was found and open appendectomy as well as a hernioplasty was performed.
Open appendectomy is an elegant and safe procedure to repair a long standing de Garengeot hernia. Most case reports call for extensive diagnostics such as CT scan etc. We found a sonography of the femoral region to be conclusive.
Apart from the inherent risk of sudden incarceration in hernias, De Garengeot hernias can also develop peracute appendicitis years after their formation. This differential diagnosis needs to be taken into consideration in patients presenting with the clinical signs of a femoral hernia.
股疝在某些罕见情况下可能包含阑尾，这种现象称为德加朗热疝。它通常是在疝修补术中偶然发现的。我们发现我们的病例很有趣，因为在急性阑尾炎导致阑尾切除之前，右侧股部肿胀已经存在很长时间了。
我们报告一例71岁女性，右侧大腿内侧肿胀超过30年。当肿胀突然增大并变得疼痛时，她被转诊至我们的急诊科。超声检查以及临床诊断均为股疝。术中发现阑尾，并进行了开放式阑尾切除术和疝修补术。
开放式阑尾切除术是修复长期存在的德加朗热疝的一种简便且安全的手术方法。大多数病例报告都需要进行诸如CT扫描等广泛的诊断。我们发现股部超声检查具有决定性作用。
除了疝突然嵌顿的固有风险外，德加朗热疝在形成数年之后也可能发展为急性阑尾炎。对于出现股疝临床体征的患者，需要考虑这种鉴别诊断。
