Chouari Tarak, Davies Timothy, Rangarajan Karan, Nicolay Christopher
Frimley Park Hospital, Frimley Health NHS Foundation Trust, Portsmouth Road, Frimley, GU16 7UJ, UK.
Int J Surg Case Rep. 2020;77:383-386. doi: 10.1016/j.ijscr.2020.10.111. Epub 2020 Oct 29.
De Garengeot's hernia is a rare type of femoral hernia which describes the vermiform appendix incarcerated within the hernia sac. In this case report we present our case and review the surgical approaches described in the literature.
We present the case of an 84-year-old female with a background of Parkinson's Disease who presented to the emergency department with a five day history of a right-sided groin lump with worsening pain, nausea and reduced appetite. Computed tomography of the abdomen and pelvis revealed an inflamed appendix herniating through the right femoral canal. She had a two staged surgical approach involving an open repair of her femoral hernia followed by laparoscopic appendicectomy.
Due to its rarity, there is no standard surgical approach to the appendicectomy and femoral hernia repair. Multiple approaches have been described in the literature, however most reports describe a simultaneous femoral hernia repair and appendicectomy. If an additional abdominal incision is required to complete the appendicectomy safely, we advocate the consideration of a hybrid open-laparoscopic approach, particularly in patients such as this with a history of Parkinson's disease.
Here we highlight the usefulness of combining an open low inguinal approach followed by a laparoscopic appendicectomy.
德加伦若疝是一种罕见的股疝类型，指疝囊内包含嵌顿的阑尾。在本病例报告中，我们展示了我们的病例并回顾了文献中描述的手术方法。
我们报告了一例84岁患有帕金森病的女性患者，她因右侧腹股沟肿块伴疼痛加重、恶心和食欲减退5天就诊于急诊科。腹部和盆腔计算机断层扫描显示发炎的阑尾通过右侧股管突出。她接受了两阶段手术，包括开放式股疝修补术，随后进行腹腔镜阑尾切除术。
由于其罕见性，阑尾切除术和股疝修补术没有标准的手术方法。文献中描述了多种方法，然而大多数报告描述的是同时进行股疝修补术和阑尾切除术。如果需要额外的腹部切口来安全完成阑尾切除术，我们主张考虑采用开放 - 腹腔镜联合方法，特别是对于像这位有帕金森病病史的患者。
在此我们强调了先采用开放式低位腹股沟入路然后进行腹腔镜阑尾切除术这种联合方法的实用性。
