Department of Surgery, Inova Fairfax Hospital, Falls Church, VA, USA.
Am Surg. 2023 May;89(5):2064-2066. doi: 10.1177/00031348211023421. Epub 2021 May 31.
Obturator hernias are quite rare in the world of hernias, and one that contains an acutely inflamed appendix becomes a very rare case indeed. An obturator hernia containing the appendix has been reported only 5 times in the surgical literature. Three of those cases were in elderly women with delayed presentations and were fatal. The most recent case was in a young woman with prompt laparoscopic appendectomy and no complications. We present a case in a 25-year-old man presenting with acute appendicitis and found to be incarcerated within the obturator canal during laparoscopy. The patient was treated with a 4-day course of postoperative antibiotics and a surgical drain that was later removed who had a full recovery. We conclude that the appropriate workup includes CT imaging and treatment with laparoscopic surgery for removal of the appendix.
闭孔疝在疝的世界中非常罕见，而疝内容物包含急性炎症的阑尾则更是罕见。在外科文献中仅报告过 5 例闭孔疝合并阑尾。其中 3 例发生在老年女性，表现为延迟出现，且均为致命性的。最近的病例是一位年轻女性，她及时接受了腹腔镜阑尾切除术，没有出现并发症。我们报告了一例 25 岁男性，表现为急性阑尾炎，在腹腔镜检查时发现疝内容物嵌顿于闭孔管内。该患者术后接受了 4 天抗生素治疗和放置引流管，后来引流管被移除，患者完全康复。我们得出结论，合适的检查包括 CT 成像和腹腔镜手术切除阑尾。
