Murad Mhd Anas, Jacob Manoj, Himpson Rebecca
General Surgery, Southend University Hospital, Mid and South Essex National Health Service (NHS) Foundation Trust, Southend-on-Sea, GBR.
Cureus. 2024 Dec 9;16(12):e75356. doi: 10.7759/cureus.75356. eCollection 2024 Dec.
De Garengeot's hernia, a femoral hernia containing an incarcerated appendix, is rarely encountered in clinical practice. We report a case of a 62-year-old woman presenting with a right groin lump. A computed tomography scan reported a right inguinal hernia containing fluid with no bowel involvement. Exploration of the right groin revealed a femoral hernia containing an inflamed appendix. Appendicectomy and suture repair of the femoral canal were performed, with histology showing a low-grade appendiceal mucinous neoplasm, which is also rare. After a discussion during the colorectal multidisciplinary team meeting and taking into consideration the patient's wishes, a decision was made regarding a complete right hemicolectomy. Histology from the subsequent surgery did not demonstrate any adverse features, and the patient was enrolled in the surveillance program. This case highlights the rarity of this finding and underscores the importance of tailoring surgical approaches based on the intraoperative findings aided by preoperative imaging and a thorough understanding of the anatomy.
德加伦若疝是一种包含嵌顿阑尾的股疝,在临床实践中很少见。我们报告一例62岁女性患者,其表现为右侧腹股沟肿块。计算机断层扫描报告显示为右侧腹股沟疝,疝内容物为液体,无肠管受累。对右侧腹股沟进行探查发现是一个包含发炎阑尾的股疝。实施了阑尾切除术和股管缝合修补术,组织学检查显示为低级别阑尾黏液性肿瘤,这也很罕见。在结直肠多学科团队会议上进行讨论并考虑患者意愿后,决定进行完整的右半结肠切除术。后续手术的组织学检查未发现任何不良特征,该患者已纳入监测计划。本病例凸显了这一发现的罕见性,并强调了根据术前影像学检查结果及对解剖结构的透彻理解,结合术中发现来调整手术方式的重要性。