Christodoulidis Gregorios, Perivoliotis Konstantinos, Diamantis Alexandros, Dimas Dionysios, Spyridakis Michael, Tepetes Konstantinos
Department of General Surgery, University Hospital of Larissa, Mezourlo, 411 10 Larissa, Greece.
Department of General Surgery, Elpis General Hospital, 115 22 Athens, Greece.
Case Rep Surg. 2017;2017:5932657. doi: 10.1155/2017/5932657. Epub 2017 Mar 22.
We report the case of an appendiceal carcinoid tumor within an Amyand's hernia, presenting as an incarcerated right inguinal hernia. A 52-year-old male presented in the emergency department due to a persistent right inguinal pain. Clinical examination revealed a tender right groin mass. Laboratory tests revealed leukocytosis and an increased serum CRP. Under the diagnosis of an incarcerated right inguinal hernia, an emergency operation was taken. Intraoperatively, an inflamed appendix and a part of the cecum were found in the hernia sac. The operation was completed with an appendectomy and a modified Bassini hernia repair. Histological examination revealed a carcinoid tumor, resulting in the performance of a right hemicolectomy. Amyand's hernia is estimated to account for 0.4% to 0.6% of all inguinal hernias. Coexistence of an Amyand's hernia and a neoplasia is quite rare. Carcinoids are the most frequent tumors found in the appendix, with the size of the primary tumor to be considered the most important prognostic factor and the basis upon which the operative plan is decided. A malignancy of the appendix should always be in the differential diagnosis of a right inguinal mass, in order to provide optimum surgical treatment.
我们报告了一例艾米安德疝内的阑尾类癌肿瘤,表现为嵌顿性右腹股沟疝。一名52岁男性因持续性右腹股沟疼痛就诊于急诊科。临床检查发现右侧腹股沟有压痛性肿块。实验室检查显示白细胞增多和血清CRP升高。在诊断为嵌顿性右腹股沟疝后,进行了急诊手术。术中,在疝囊内发现了发炎的阑尾和部分盲肠。手术以阑尾切除术和改良的巴西尼疝修补术完成。组织学检查显示为类癌肿瘤,因此进行了右半结肠切除术。据估计,艾米安德疝占所有腹股沟疝的0.4%至0.6%。艾米安德疝与肿瘤并存的情况相当罕见。类癌是阑尾中最常见的肿瘤,原发肿瘤的大小被认为是最重要的预后因素,也是决定手术方案的依据。为了提供最佳的手术治疗,在鉴别诊断右腹股沟肿块时应始终考虑阑尾恶性肿瘤。