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股疝合并阑尾黏液性肿瘤:一例报告

Appendiceal Mucinous Neoplasm in a De Garengeot Hernia: A Case Report.

作者信息

Murad Mhd Anas, Jacob Manoj, Himpson Rebecca

机构信息

General Surgery, Southend University Hospital, Mid and South Essex National Health Service (NHS) Foundation Trust, Southend-on-Sea, GBR.

出版信息

Cureus. 2024 Dec 9;16(12):e75356. doi: 10.7759/cureus.75356. eCollection 2024 Dec.

DOI:10.7759/cureus.75356
PMID:39660229
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11629595/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b78/11629595/84b6a91c36f2/cureus-0016-00000075356-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b78/11629595/6e4e3aba71aa/cureus-0016-00000075356-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b78/11629595/84b6a91c36f2/cureus-0016-00000075356-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b78/11629595/6e4e3aba71aa/cureus-0016-00000075356-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b78/11629595/84b6a91c36f2/cureus-0016-00000075356-i02.jpg

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本文引用的文献

1
Acute appendicitis in the context of De Garengeot hernia: a case report.德加伦若疝并发急性阑尾炎:一例报告
J Surg Case Rep. 2022 Jul 23;2022(7):rjac189. doi: 10.1093/jscr/rjac189. eCollection 2022 Jul.
2
Mucinous Adenocarcinoma of the Appendix With Histologic Response to Neoadjuvant Chemotherapy: Review of Histologic and Clinical Spectrum of Epithelial Neoplastic Mucinous Lesions of the Appendix.阑尾黏液腺癌伴有新辅助化疗的组织学反应:阑尾上皮性黏液性肿瘤病变的组织学和临床谱的回顾。
Oncology (Williston Park). 2021 Jun 23;35(6):335-340. doi: 10.46883/ONC.2021.3506.0335.
3
De Garengeot hernia: a rare case in an elderly woman and a review of operative approaches.
De Garengeot 疝:老年女性罕见病例及手术入路的回顾。
BMJ Case Rep. 2021 Apr 16;14(4):e240557. doi: 10.1136/bcr-2020-240557.
4
de Garengeot hernia with a mucinous neoplasm of the appendix, two clinical rarities combine to yield a first for the literature.伴有阑尾黏液性肿瘤的加朗热疝,两种临床罕见情况同时出现,这在文献中尚属首次。
BMJ Case Rep. 2017 Jun 13;2017:bcr-2017-220830. doi: 10.1136/bcr-2017-220830.
5
Case Report: De Garengeot's hernia. Appendicitis within femoral hernia. Diagnosis and surgical management.病例报告:加朗若疝。股疝合并阑尾炎。诊断与手术治疗。
Int J Surg Case Rep. 2016;27:162-164. doi: 10.1016/j.ijscr.2016.08.042. Epub 2016 Sep 4.
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Inflamed appendix in a femoral hernial sac: de Garengeot's hernia.股疝囊内的发炎阑尾:加朗热疝
Hernia. 2009 Oct;13(5):551-3. doi: 10.1007/s10029-009-0472-7. Epub 2009 Feb 19.
7
De Garengeot hernia: appendicitis within a femoral hernia.德加伦若疝:股疝内合并阑尾炎。
Am Surg. 2005 Jun;71(6):526-7.
8
STRANGULATED FEMORAL HERNIA APPENDIX WITH PERFORATED SIGMOID DIVERTICULITIS.绞窄性股疝伴穿孔性乙状结肠憩室炎附录(此“附录”在文本中似乎不太符合正常语境,疑有误,推测原文可能是“绞窄性股疝伴穿孔性乙状结肠憩室炎”)
Proc R Soc Med. 1963 Dec;56(12):1105-6. doi: 10.1177/003591576305601226.