Corvatta Franco A, Palacios Huatuco René M, Bertone Santiago, Viñas José F
General Surgery Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.
Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires School of Medicine, Hospital Italiano de Buenos Aires University Institute, Buenos Aires, Argentina.
Surg Case Rep. 2023 Feb 1;9(1):15. doi: 10.1186/s40792-023-01597-9.
The finding of a vermiform appendix within the peritoneal sac of an inguinal hernia is called Amyand's hernia. The reported incidence of Amyand's hernia and femoral hernia is 1% and 3.8%, respectively. To our knowledge, no cases have been reported in the literature that associate these two entities. We present the first case of incarcerated left-sided Amyand's hernia and synchronous ipsilateral femoral hernia found during emergency surgery.
A 72-year-old woman was admitted to the Emergency Department for a complicated left inguinal hernia. An inguinotomy was performed that detected a large direct hernial sac and a synchronous femoral hernia. The opening of the inguinal hernia showed the presence of the cecum and the appendix, both without signs of inflammation. The femoral space was evaluated transinguinally, identifying the larger omentum that had slipped into the femoral canal. The primary closure of the posterior wall defect was performed with the McVay technique due to its large size, and then the hernioplasty was completed with a polypropylene mesh. No postoperative complications were reported.
In the context of an incarcerated Amyand's hernia, the decision to perform an appendectomy in addition to hernia repair with or without mesh will depend on intraoperative findings.
在腹股沟疝的腹膜囊中发现阑尾称为阿米亚德疝。据报道，阿米亚德疝和股疝的发病率分别为1%和3.8%。据我们所知，文献中尚未报道过将这两种情况关联起来的病例。我们报告了在急诊手术中发现的第一例嵌顿性左侧阿米亚德疝并同侧股疝的病例。
一名72岁女性因复杂的左侧腹股沟疝入住急诊科。进行了腹股沟切开术，发现一个大的直疝囊和一个同步的股疝。腹股沟疝开口处可见盲肠和阑尾，均无炎症迹象。经腹股沟评估股管间隙，发现较大的网膜滑入股管。由于后壁缺损较大，采用麦克维技术进行了后壁缺损的一期缝合，然后用聚丙烯网片完成疝修补术。术后未报告并发症。
在嵌顿性阿米亚德疝的情况下，除疝修补术（有或无网片）外是否进行阑尾切除术将取决于术中发现。
