Imataki Hiromitsu, Miyake Hideo, Nagai Hidemasa, Yoshioka Yuichiro, Shibata Koji, Kambara Yuichi, Yuasa Norihiro
Department of Gastrointestinal Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan.
Surg Case Rep. 2021 Nov 22;7(1):246. doi: 10.1186/s40792-021-01329-x.
Emergency appendectomy is often performed for de Garengeot hernia. However, in some cases, there may be a chance to perform an appendix-preserving elective surgery.
A 76-year-old woman presented to our hospital with complaints of a right inguinal swelling, which we diagnosed as a de Garengeot hernia using computed tomography (CT). B-mode ultrasonography (US) of the mass showed an appendix 4-6 mm in diameter with a clear wall structure; color Doppler US showed pulsatile blood flow signal in the appendiceal wall. Twenty-eight days later, herniorrhaphy with transabdominal preperitoneal repair (TAPP) was performed without appendectomy. Another 70-year-old woman presented to our hospital with complaints of a painful bulge in the right inguinal region. The diagnosis of de Garengeot hernia was made using CT. B-mode US showed an appendix 5 mm in diameter with a clear wall structure. Color Doppler US showed a pulsatile blood signal in the appendiceal wall. Seven days later, herniorrhaphy with TAPP was performed without appendectomy.
De Garengeot hernia is often associated with appendicitis; however, an appendix-preserving elective herniorrhaphy can be performed if US and intraoperative findings do not suggest appendicitis or circulatory compromise in the appendix.
急诊阑尾切除术常用于治疗梨状肌疝。然而，在某些情况下，可能有机会进行保留阑尾的择期手术。
一名76岁女性因右侧腹股沟肿胀就诊于我院，我们通过计算机断层扫描（CT）诊断为梨状肌疝。对肿块进行B型超声检查（US）显示阑尾直径为4 - 6毫米，壁结构清晰；彩色多普勒超声显示阑尾壁有搏动性血流信号。28天后，进行了经腹腹膜前修补术（TAPP）疝修补术，未行阑尾切除术。另一名70岁女性因右侧腹股沟区疼痛性肿块就诊于我院。通过CT诊断为梨状肌疝。B型超声显示阑尾直径5毫米，壁结构清晰。彩色多普勒超声显示阑尾壁有搏动性血流信号。7天后，进行了TAPP疝修补术，未行阑尾切除术。
梨状肌疝常与阑尾炎相关；然而，如果超声和术中检查结果未提示阑尾炎或阑尾血运障碍，则可进行保留阑尾的择期疝修补术。
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