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德加伦若疝合并阑尾炎:一种罕见的表现

Appendicitis in De Garengeot Hernia: A Rare Presentation.

作者信息

Alkhalifa Ahmed A, Alabbad Mohammed, Alshahri Hassan M, Aljughaiman Buthainah, Helal Hazem F, Al Omair Abdulmajeed M, Almohammedsaleh Othman, Amro Nizar M, Odeh Ahmed M

机构信息

General and Laparoscopic Surgery, Al Ahsa Health Cluster, Al Ahsa, SAU.

General Surgery, Al Ahsa Health Cluster, Al Ahsa, SAU.

出版信息

Cureus. 2024 Aug 31;16(8):e68352. doi: 10.7759/cureus.68352. eCollection 2024 Aug.

DOI:10.7759/cureus.68352
PMID:39355072
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11443476/
Abstract

De Garengeot hernia, a rare clinical entity characterized by the presence of the appendix within a femoral hernia sac, is a challenging condition often requiring prompt surgical intervention. Fewer than 100 cases have been reported in the literature containing appendicitis in de Garengeot hernia. We present a case of a 40-year-old female with a preoperatively diagnosed De Garengeot hernia with appendicitis. The patient presented with a painful and irreducible right groin swelling, and imaging revealed a femoral hernia containing an inflamed appendix. Urgent surgical intervention was undertaken, involving right femoral hernia repair and appendectomy. The surgical procedure, utilizing the infra-inguinal approach, proceeded uneventfully, with the patient recovering well postoperatively. De Garengeot hernia is a rare clinical presentation with no established treatment guidelines. Surgical management typically involves hernia repair and appendectomy, with the choice of repair method dependent on intraoperative findings. The use of prosthetic mesh in contaminated fields remains controversial, with considerations for infection risk and patient outcomes. Early diagnosis and appropriate surgical intervention are essential in managing De Garengeot hernia to prevent complications and ensure favourable patient outcomes. This case underscores the importance of recognizing and effectively treating this uncommon surgical condition.

摘要

德加伦若疝是一种罕见的临床病症,其特征为股疝囊内存在阑尾,是一种具有挑战性的病症,通常需要及时进行手术干预。文献中报道的合并阑尾炎的德加伦若疝病例不足100例。我们报告一例40岁女性患者,术前诊断为合并阑尾炎的德加伦若疝。患者表现为右侧腹股沟疼痛且无法回纳的肿胀,影像学检查显示股疝内有发炎的阑尾。进行了紧急手术干预,包括右侧股疝修补术和阑尾切除术。采用腹股沟下入路的手术过程顺利,患者术后恢复良好。德加伦若疝是一种罕见的临床表现,尚无既定的治疗指南。手术管理通常包括疝修补术和阑尾切除术,修复方法的选择取决于术中发现。在污染区域使用人工补片仍存在争议,需考虑感染风险和患者预后。早期诊断和适当的手术干预对于管理德加伦若疝以预防并发症和确保患者获得良好预后至关重要。本病例强调了认识并有效治疗这种罕见外科病症的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cba/11443476/6e216d5cd7fb/cureus-0016-00000068352-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cba/11443476/c450e9242d3f/cureus-0016-00000068352-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cba/11443476/0e8d7c2d6822/cureus-0016-00000068352-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cba/11443476/bc86185cc383/cureus-0016-00000068352-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cba/11443476/8d5bb69426af/cureus-0016-00000068352-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cba/11443476/6dae228f3370/cureus-0016-00000068352-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cba/11443476/875fe5a688ed/cureus-0016-00000068352-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cba/11443476/6e216d5cd7fb/cureus-0016-00000068352-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cba/11443476/c450e9242d3f/cureus-0016-00000068352-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cba/11443476/0e8d7c2d6822/cureus-0016-00000068352-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cba/11443476/bc86185cc383/cureus-0016-00000068352-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cba/11443476/8d5bb69426af/cureus-0016-00000068352-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cba/11443476/6dae228f3370/cureus-0016-00000068352-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cba/11443476/875fe5a688ed/cureus-0016-00000068352-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cba/11443476/6e216d5cd7fb/cureus-0016-00000068352-i07.jpg

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本文引用的文献

1
De Garengeot Hernia, an acute appendicitis in the right femoral hernia canal, and successful management with transabdominal closure and appendectomy: a case Report.De Garengeot 疝,右侧股疝管内急性阑尾炎,经腹闭合法和阑尾切除术成功治疗:一例报告。
BMC Urol. 2024 Feb 16;24(1):41. doi: 10.1186/s12894-023-01383-7.
2
De Garengeot hernia: a systematic review.De Garengeot 疝:系统评价。
Surg Endosc. 2021 Feb;35(2):503-513. doi: 10.1007/s00464-020-07934-5. Epub 2020 Sep 2.
3
A case of De Garengeot hernia and literature review.
一例梨状肌下疝并文献复习
BMJ Case Rep. 2017 Sep 7;2017:bcr-2017-220926. doi: 10.1136/bcr-2017-220926.
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De Garengeot's hernia: Incarcerated femoral hernia containing the vermiform appendix. Report of two cases and literature review.
Cir Esp. 2017 Mar;95(3):177-178. doi: 10.1016/j.ciresp.2016.08.005. Epub 2016 Nov 16.
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A case of de Garengeot hernia: the feasibility of laparoscopic transabdominal preperitoneal hernia repair.一例加朗热奥疝:腹腔镜经腹腹膜前疝修补术的可行性
Int J Surg Case Rep. 2015;16:73-6. doi: 10.1016/j.ijscr.2015.09.021. Epub 2015 Sep 25.
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De Garengeot hernia: Case report and review.加朗若疝:病例报告与综述
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Acute Appendicitis in an Incarcerated Femoral Hernia: A Case of De Garengeot Hernia.嵌顿性股疝合并急性阑尾炎:1例加伦若疝病例
Case Rep Gastroenterol. 2009 Nov 20;3(3):313-317. doi: 10.1159/000250821.
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De Garengeot hernia.加朗热奥疝
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Hernia. 2007 Jun;11(3):235-8. doi: 10.1007/s10029-007-0208-5. Epub 2007 Mar 6.