Al-Ramli Wisam, Khodear Yahya, Aremu Muyiwa, El-Sayed Abdel Basset
Department of General Surgery, Letterkenny University Hospital, Ireland.
Department of General Surgery, Letterkenny University Hospital, Ireland.
Int J Surg Case Rep. 2016;29:215-218. doi: 10.1016/j.ijscr.2016.11.010. Epub 2016 Nov 10.
Amyand's hernia is a rare condition of inguinal hernia in which the appendix is incarcerated within the hernia sac through the internal ring. Complications include acute appendicitis and perforated appendicitis, which are rare in incidence, accounting for about 0.1% of cases. These complications prove a diagnostic challenge due to their vague clinical presentation and atypical laboratory and radiological findings. Until recently, open appendectomy was the mainstay of treatment. Laparoscopic surgery offers a less invasive approach to confirming a diagnosis and serving as a therapeutic tool in equivocal cases.
We report a case of a previously healthy 20-year-old male presenting with atypical signs and symptoms, as well as blood investigation results, and radiological findings of a perforated appendix within an Amyand's hernia. The patient was successfully managed using a minimally invasive laparoscopic appendectomy approach.
Until recently, open appendectomy was considered the mainstay in the management of complicated Amyand's hernia. Laparoscopic surgery provides a new avenue for dealing with diagnostic uncertainty with advantages including faster recovery time, reduced hospital stay, and better quality of life.
This case report highlights the concealing effects of an Amyand's hernia on a perforated appendix, the considerations required when an equivocal diagnosis present and the safe use of the minimally invasive laparoscopic surgery in the treatment of this rare condition.
艾米安德疝是一种罕见的腹股沟疝,阑尾通过内环被嵌顿在疝囊内。并发症包括急性阑尾炎和穿孔性阑尾炎,其发病率很低,约占病例的0.1%。由于临床表现模糊以及实验室和影像学检查结果不典型,这些并发症构成了诊断挑战。直到最近,开放阑尾切除术一直是主要的治疗方法。腹腔镜手术提供了一种侵入性较小的方法,用于在疑难病例中确诊并作为治疗手段。
我们报告一例病例,一名20岁既往健康的男性,表现出非典型的体征和症状,以及血液检查结果和艾米安德疝内穿孔性阑尾的影像学表现。该患者通过微创腹腔镜阑尾切除术方法成功得到治疗。
直到最近,开放阑尾切除术一直被认为是复杂艾米安德疝治疗的主要方法。腹腔镜手术为处理诊断不确定性提供了一条新途径,其优点包括恢复时间更快、住院时间缩短和生活质量提高。
本病例报告强调了艾米安德疝对穿孔性阑尾的隐匿作用,出现疑难诊断时所需的考虑因素,以及在治疗这种罕见疾病时安全使用微创腹腔镜手术。