Jackman Jamaall, Aswad Mayar Ghazal, Chowdhury Abeed
Queen's Medical Centre, Nottingham University Hospitals Trust, UK.
Queen's Medical Centre, Nottingham University Hospitals Trust, UK.
Int J Surg Case Rep. 2020;76:107-110. doi: 10.1016/j.ijscr.2020.09.102. Epub 2020 Sep 21.
De Garengeot's hernia is rare and describes a femoral hernia containing the vermiform appendix. Pre-operative diagnosis is at times difficult and operative intervention can prove challenging.
We report a case of a 75-year-old woman with a swelling to the right groin for over 10 years which increased in size and became intermittently painful over a period of two weeks. Patient stated that an earlier consult was not sought as she had concerns about having to stay in hospital with the ongoing global pandemic and her significant cardiac history. Ultrasound and contrast enhanced Computed Tomography (CT) revealed typical radiological features of an inflamed appendix herniating through the femoral canal.
Due to its rarity a preoperative diagnosis of a de Garengeot hernia may be difficult. There is currently no consensus to surgical approach in this setting, management is widely varied and based on the preference and expertise available during these emergency procedures.
The de Garengeot hernia though uncommon should be recognised as a differential when faced with an incarcerated femoral hernia. To the best of our knowledge, this is the first case that combines ultrasound, CT findings and a preperitoneal surgical intervention.
德加伦若疝较为罕见，指的是包含阑尾的股疝。术前诊断有时较为困难，手术干预也颇具挑战性。
我们报告一例75岁女性患者，其右侧腹股沟肿胀超过10年，在两周内肿大且间歇性疼痛。患者表示，由于担心在全球疫情期间住院以及自身严重的心脏病史，此前未寻求咨询。超声和增强计算机断层扫描（CT）显示典型的影像学特征，即发炎的阑尾经股管突出。
由于其罕见性，术前诊断德加伦若疝可能较为困难。目前在这种情况下对于手术方式尚无共识，处理方式差异很大，取决于这些急诊手术时可用的偏好和专业知识。
德加伦若疝虽不常见，但在面对嵌顿性股疝时应作为鉴别诊断考虑。据我们所知，这是首例结合超声、CT检查结果及腹膜前手术干预的病例。
