Arenas Daniel J, Hernandez Paul T, Hwang Jasmine, Agarwal Divyansh, Warshauer Alexander K, Holena Daniel N
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Division of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
J Surg Case Rep. 2022 Jun 3;2022(6):rjab489. doi: 10.1093/jscr/rjab489. eCollection 2022 Jun.
Amyand's hernia, an incarcerated appendix inside an inguinal hernia, accounts for <1% of hernias in children and even less in adults. Similarly, low-grade appendiceal mucinous (LAMN) lesions are only found in <1% of removed appendices. We present the case of a 72-year-old man with a 15-year history of a large right inguinoscrotal hernia that presented with right lower quadrant pain, was found by computed tomography imaging to have an incarcerated appendix with a large fluid collection, and was post-operatively diagnosed with an LAMN lesion. Although our case is rare due to the simultaneity of the Amyand's hernia and LAMN conditions, each separate condition is prevalent enough for most surgical providers to encounter at least one of these. For our case, we discuss the decisions made in the pre-operative and post-operative management and relevant literature.
艾米安德疝是指腹股沟疝内包含嵌顿性阑尾,在儿童疝中占比不到1%,在成人中占比更低。同样,低级别阑尾黏液性(LAMN)病变仅在不到1%的切除阑尾中被发现。我们报告一例72岁男性患者,有15年右侧腹股沟阴囊大疝病史,因右下腹疼痛就诊,计算机断层扫描成像发现有嵌顿性阑尾伴大量液体积聚,术后诊断为LAMN病变。尽管由于艾米安德疝和LAMN情况同时存在,我们的病例很罕见,但每种单独的情况都足够常见,大多数外科医生至少会遇到其中一种。对于我们的病例,我们讨论了术前和术后管理中做出的决策以及相关文献。