Lakhani Dhairya A, Dada Jafar, Balar Aneri B, Khan Ahsan U, Patel Zalak, Markovich Brian, Nguyen Thuan-Phuong
Department of Radiology, School of Medicine, West Virginia University, Morgantown, WV.
Section of Abdominal Radiology, Department of Radiology, School of Medicine, West Virginia University, Morgantown, WV.
Radiol Case Rep. 2021 May 1;16(7):1736-1739. doi: 10.1016/j.radcr.2021.04.026. eCollection 2021 Jul.
Acute appendicitis is a surgical emergency. However, the presence of vermiform appendix in a hernial sac is rare. It is even rarer to find inflamed appendix in an hernial sac. The most common site is right groin hernia (Inguinal > Femoral). There is low incidence of an incisional hernia following renal transplantation, as compared to patients with laparotomy. Appendicitis in hernial sac masquerades clinical presentation of an incarcerated hernia. Computed tomography plays a pivotal role in early diagnosis, demonstrating a dilated appendix with wall thickening and peri-appendiceal fat stranding. Patients are managed with appendectomy. The management of appendiceal hernias without inflammation remains controversial, with few reported cases managed with hernia sac repair or appendectomy. In this report were described a case of appendicitis in an incisional hernia following renal transplantation which was managed with appendectomy.
急性阑尾炎是一种外科急症。然而,阑尾位于疝囊内的情况很少见。在疝囊内发现发炎的阑尾则更为罕见。最常见的部位是右侧腹股沟疝(腹股沟疝>股疝)。与接受剖腹手术的患者相比,肾移植后切口疝的发生率较低。疝囊内的阑尾炎会伪装成嵌顿疝的临床表现。计算机断层扫描在早期诊断中起着关键作用,显示阑尾扩张、壁增厚和阑尾周围脂肪条索状改变。患者接受阑尾切除术治疗。对于无炎症的阑尾疝的处理仍存在争议,仅有少数病例报道采用疝囊修补术或阑尾切除术治疗。在本报告中,描述了一例肾移植后切口疝合并阑尾炎的病例,该病例接受了阑尾切除术治疗。