Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania.
Center of Abdominal Surgery, Clinic of Gastroenterology, Nephrourology, and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania.
Medicina (Kaunas). 2023 Mar 10;59(3):538. doi: 10.3390/medicina59030538.
: Appendicitis within incisional hernia is an extraordinarily rare postoperative complication with an incidence range from 0.08 to 1%. From the 14 cases that we found in the English literature, only three present appendixes vermiform in incisional hernia followed by laparoscopic surgery. Only two cases are treated minimally invasively by the laparoscopic approach. : We introduce a 65-year-old man who had a laparoscopic sigmoid colon resection and had a lump found at the 12 mm trocar site in the right iliac area in the late postoperative phase. There were no complaints from the patient. A vermiform appendix was unexpectedly discovered in the sac of that incisional hernia during control CT scans performed by chemotherapists. Laparoscopic hernia repair without appendectomy was performed. Postoperative outcomes were excellent. : Because of low incidence and a lack of distinctive clinical presentation of appendicitis within incisional hernia, there is a risk of delayed perioperative diagnosis and treatment. A CT scan might play an important role in verifying the diagnosis early. For better postoperative outcomes, if possible, laparoscopic surgery should be chosen.
切口疝内阑尾炎是一种极为罕见的术后并发症，其发病率范围为 0.08%至 1%。在我们在英文文献中发现的 14 个病例中，只有 3 例表现为切口疝内的阑尾呈蚓状，随后进行腹腔镜手术。仅 2 例通过腹腔镜方法进行微创治疗。我们介绍了一位 65 岁男性，他接受了腹腔镜乙状结肠切除术，在术后晚期右侧髂区 12 毫米 trocar 部位发现肿块。患者没有任何不适。在接受化疗师进行的 CT 扫描时，意外地在那个切口疝的囊内发现了一个阑尾。我们进行了腹腔镜疝修补术，而没有进行阑尾切除术。术后结果非常好。由于切口疝内阑尾炎的发病率低且临床表现不明显，存在围手术期诊断和治疗延迟的风险。CT 扫描可能在早期确诊方面发挥重要作用。为了获得更好的术后结果，如果可能，应选择腹腔镜手术。
