Garcia-Amador Cristina, De la Plaza Roberto, Arteaga Vladimir, Lopez-Marcano Aylhin, Ramia Jose
C/Donantes de Sangre s/n, Guadalajara 19002, Spain.
Department of Surgery, Hospital Universitario de Guadalajara, C/Donantes de Sangre s/n, Guadalajara 19002, Spain.
Open Med (Wars). 2016 Oct 7;11(1):354-360. doi: 10.1515/med-2016-0065. eCollection 2016.
Garengeot's hernia (GH) is defined as the presence of the appendix inside a femoral hernia. It occurs in 0.9% of femoral hernias and is usually an incidental finding during surgery. Its treatment is controversial and the aim of this article is to review the diagnostic methods and surgical considerations. We report two cases diagnosed preoperatively by contrast-enhanced computed tomography (CT) and discuss the treatment options based on a review of the literature published in PubMed updated on 1 December, 2015. Fifty articles reporting 64 patients (50 women, mean age 70 years) with GH were included in the analysis. Diagnosis was performed by preoperative CT in only 24 cases, including our two. The treatment of GH is emergency surgery. Several options are available laparoscopic or open approach: insertion of a mesh or simple herniorrhaphy, with or without appendectomy.
The preoperative diagnosis with CT can guide the choice of treatment. Appendectomy and hernioplasty should be performed via inguinotomy, if there is no perforation or abscess formation.
加朗热疝(GH)定义为股疝内存在阑尾。它在股疝中发生率为0.9%,通常是手术中的偶然发现。其治疗存在争议,本文旨在综述诊断方法及手术注意事项。我们报告两例术前经对比增强计算机断层扫描(CT)诊断的病例,并基于对2015年12月1日更新的PubMed上发表的文献综述讨论治疗方案。分析纳入了50篇报告64例(50名女性,平均年龄70岁)加朗热疝患者的文章。仅24例(包括我们的两例)通过术前CT进行诊断。加朗热疝的治疗为急诊手术。有几种选择,腹腔镜或开放手术方式:放置补片或单纯疝修补术,伴或不伴阑尾切除术。
CT术前诊断可指导治疗选择。如果没有穿孔或脓肿形成,应通过腹股沟切开术进行阑尾切除术和疝修补术。