Sharma Davek, Katsnelson Jacob, Nwachuku Emmanuel, Kolff Jeffrey
Department of General Surgery, Abington Hospital, Jefferson Health, 1200 Old York Rd., Abington, PA, 19001, United States.
Int J Surg Case Rep. 2020;76:46-48. doi: 10.1016/j.ijscr.2020.08.053. Epub 2020 Sep 24.
A De Garengeot hernia is defined by a femoral hernia containing the appendix. Acute appendicitis within a femoral hernia is an extremely rare surgical presentation and occurs in only 0.08-0.013% of cases as cited by the literature.
A 64-year-old female presented to the Emergency Department of our hospital with acute onset of a right-sided groin bulge that occurred earlier that day after doing heavy lifting. Her workup revealed acute appendicitis contained within an incarcerated right femoral hernia. The patient underwent laparoscopic appendectomy with open femoral hernia repair. Intraoperatively, the appendiceal tip was incarcerated within the hernia sac. It was removed through the open inguinal incision after the appendix base was divided laparoscopically. Final pathology showed inflamed acute appendicitis without evidence for neoplasm.
Physicians should be aware of the rare entity of an unusual presentation of appendicitis as well as surgical options for treatment. The literature does not conclude upon a gold standard for method of approach.
De Garengeot hernia remains a rare and unusual surgical presentation of femoral hernia, and complication of the case by incarceration leading to acute appendicitis provides a challenging surgical approach which should be individualized to each patient.
德加朗若疝的定义为包含阑尾的股疝。股疝内的急性阑尾炎是一种极为罕见的外科表现，据文献报道，其发生率仅为0.08 - 0.013%。
一名64岁女性因当日早些时候搬运重物后突发右侧腹股沟肿块而就诊于我院急诊科。检查发现为嵌顿性右侧股疝合并急性阑尾炎。患者接受了腹腔镜阑尾切除术及开放性股疝修补术。术中，阑尾尖端嵌顿于疝囊内。在腹腔镜下离断阑尾根部后，通过开放腹股沟切口将其取出。最终病理显示为炎症性急性阑尾炎，无肿瘤证据。
医生应了解阑尾炎这种不寻常表现的罕见情况以及手术治疗选择。文献中并未得出一种方法的金标准。
德加朗若疝仍然是一种罕见且不寻常的股疝外科表现，该病例因嵌顿导致急性阑尾炎的并发症提供了一种具有挑战性的手术方法，应针对每个患者进行个体化处理。
