Vermiform Appendix During the Repackaging Process from Umbilical Herniation to Fixation onto the Right Posterior Abdomen

2019 ◽  
Vol 33 (5) ◽  
pp. 667-677
Author(s):  
Ji H. Kim ◽  
Zhe W. Jin ◽  
Shunichi Shibata ◽  
Gen Murakami ◽  
Shogo Hayashi ◽  
...  
2016 ◽  
Vol 98 (7) ◽  
pp. e141-e142 ◽  
Author(s):  
SH Rossi ◽  
E Coveney

A de Garengeot hernia is defined as an incarcerated femoral hernia containing the vermiform appendix. We describe the case of a patient with a type 4 appendiceal diverticulum within a de Garengeot hernia and delineate valuable learning points.A 76-year-old woman presented with a 2-week history of a non-reducible painless femoral mass. Outpatient ultrasonography demonstrated a 36mm × 20mm smooth walled, multiloculated, partially cystic lesion anterior to the right inguinal ligament in keeping with an incarcerated femoral hernia. Intraoperatively, the appendix was found to be incarcerated in the sac of the femoral hernia and appendicectomy was performed. Histopathology demonstrated no evidence of inflammation in the appendix. However, an incidental appendiceal diverticulum was identified.It is widely recognised that a de Garengeot hernia may present with concomitant appendicitis, secondary to raised intraluminal pressure in the incarcerated appendix. Appendiceal diverticulosis is also believed to develop in response to raised pressure in the appendix and may therefore develop secondary to incarceration in a de Garengeot hernia. To our knowledge, only one such case has been described in the literature. A de Garengeot hernia is a rare entity, which poses significant diagnostic challenges. A high index of clinical suspicion is necessary as these hernias are at particularly high risk of perforation and so prompt surgical management is paramount.


Author(s):  
Badri V. Sigua ◽  
Vyacheslav P. Zemlyanoy ◽  
Elguja L. Lataria ◽  
Alexey A. Kurkov ◽  
Vyacheslav A. Melnikov ◽  
...  

The mucocele of the appendix is the expansion of the appendix with the accumulation of a large amount of mucus. The mechanism and causes of mucocele are not fully understood. According to some authors, such changes in the appendix can occur due to cicatricial narrowing of the lumen of the appendix, compression or blockage of its base. Other authors believe that the mucocele of the appendix is a benign tumor that develops from the remnants of primitive mesenchyme and is sometimes prone to malignancy. Clinical manifestations of mucocele of the appendix are nonspecific. In a number of patients, this disease causes pain in the right abdomen, more often pulling, intermittent. However, the disease is often asymptomatic. In this regard, diagnosis is established only during performing an operation, most often, regarding acute appendicitis. Nevertheless, instrumental diagnostic methods such as ultrasound and computed tomography of the abdominal and pelvic organs make it possible to suspect mucocele. Despite the frequent asymptomatic, non-aggressive course, a number of life-threatening complications can become the outcome of the mucocele of the vermiform appendix. The most formidable complication is the rupture of the appendix with mucus entering free abdominal cavity, followed by the development of peritoneal pseudomyxoma due to implantation of mucus-forming cells. The only option for radical treatment of the mucocele of the appendix is a surgical intervention. A presented clinical case demonstrates the difficulties of diagnosis, as well as the features of surgical treatment of a patient with a mucocele of the appendix.


2020 ◽  
Vol 8 (12) ◽  
pp. 842-846
Author(s):  
Yehouenou Tessi T. Romeo ◽  
◽  
Asaad El Bakkari ◽  
Adeyemi A. Boris ◽  
Khadija Ben El Hosni ◽  
...  

Mucocele of the appendix is a descriptive term for mucinous distension of the appendiceal lumen (vermiform appendix) regardless of the underlying pathology. It refers to the progressive retrograde dilatation of the vermiform appendix with concomitant intraluminal accumulation of the mucoid substance. It is an uncommon pathology that occurs in both sexes. it especially poses the problem of differential diagnosis in particular in women because of the location of clinical symptoms in the right iliac fossa. The incidence is estimated between 0.2 % and 0.4 % of the appendectomied specimens.The estimated incidence is approximately 1/1 000 000/year. The disease onset is usually after the age of 40 years and more frequently affects females.The means of medical imaging are mainly ultrasound and scanner. On CT typical mucocele appears as a cecal-based, rounded and well-defined mass, thin-walled, with fine parietal calcifications CT density is variable, from fluid to tissue. A stercolith is sometimes visible at the base of the appendix. The wall of the mucocele may be thickened, irregular, taking the contrast there may be peri-appendicular inflammation, which may be inflammatory or tumor, without specificity.The treatment of unbroken appendicular mucocele is surgical, preferably by laparotomy than laparoscopy. The appendectomy is performed, without breaking the appendix, with complete resection of the meso-appendix, and sampling for cytology of the peritoneal fluid.


2002 ◽  
Vol 90 ◽  
pp. e1-e3
Author(s):  
L. Safarik ◽  
T. Hanus ◽  
J. Dvoracek

2019 ◽  
Vol 2019 (9) ◽  
Author(s):  
Ammar Omran ◽  
Bardisan Sleman Gawrieh ◽  
Aras Abdo ◽  
Mohammad Ali Deeb ◽  
Mohammad Almahmod Khalil ◽  
...  

Abstract The presence of vermiform appendix in an inguinal hernia sac is known as Amyand’s hernia. This research paper examines the case of a 28-day-old Syrian male presented with a history of an infected right-sided hydrocele from the age of 14 days. Upon admission, ultrasonography was reported as a right testicular torsion. Accordingly, emergency surgical exploration was performed, and by exposing the spermatic cord fascia, 7 mL of pus was drained, revealing the cecum and perforated appendix lying beside the right testis, which showed evidence of ischemia and bluish discoloration.


2021 ◽  
Vol 8 (4) ◽  
pp. 1337
Author(s):  
Arul K. Chinnappan ◽  
Shanthi P. Swaminathan ◽  
Vikas Kawarat ◽  
Rajeswari Mani ◽  
Indrajit Anandakannan ◽  
...  

Inguinal hernia in females is relatively uncommon as compared to males. It is interesting to note that 1 male in 5 and 1 female in 50 will eventually develop an inguinal hernia in a lifetime. The hernia sac may contain unusual structures such as the vermiform appendix, acute appendicitis, ovary, fallopian tube and, urinary bladder. Here we present a case of 20-year-old female presented with complaints of swelling in the right inguinal region. Diagnosed as a case of right inguinal hernia with Broad ligament cyst as content. Managed by laparoscopic excision of cyst and then right Lichtenstein repair for inguinal hernia.


2008 ◽  
Vol 6 (1) ◽  
pp. 0-0
Author(s):  
Eglė Zakarauskaitė ◽  
Raimundas Lunevičius

Eglė Zakarauskaitė, Raimundas LunevičiusVilniaus universitetas, Gastroenterologijos, chirurgijos ir nefrourologijos klinikosBendrosios chirurgijos centras, Vilniaus universitetinė greitosios pagalbos ligoninė,Šiltnamių g. 29, LT-04130 VilniusEl paštas: [email protected] Tikslas Aprašyti ir įvertinti visišką klubinės žarnos galinės dalies obstrukcinį nepraeinamumą dėl jos užspaudimo atipinės padėties kirmėlinės ataugos kilpa suaugusiam pacientui. Klinikinis atvejis Ligonis B. A., 71 metų, dėl sąrėmių pobūdžio skausmų visame pilvo plote, pilvo pūtimo ir pykinimo skubos tvarka hospitalizuotas į pilvo chirurgijos skyrių. Pacientas anksčiau nė karto nebuvo operuotas. Objektyvaus tyrimo rezultatai: pilvas išsipūtęs, skausmingas, maksimalaus skausmingumo ir pilvaplėvės dirginimo vieta – dešinioji klubinė sritis, auskultuojant žarnyną girdėti kliūtinė peristaltika. Apžvalginėje pilvo rentgenogramoje matyti daug Kloiberio dubenėlių išsipūtusioje plonojoje žarnoje. Diagnozavus konservatyviam gydymui atsparų visišką mechaninį žarnyno nepraeinamumą, atlikta vidurinė laparotomija. Operaciniai radiniai: stipriai išsipūtusi, iki galinės dalies perpildyta skysčių ir dujų plonoji žarna. Priežastis – apie galinę klubinės žarnos dalį kilpa apsisukusi, ją visiškai užspaudusi ir prie jos priekinės dalies pasaito prisitvirtinusi kirmėlinė atauga. Atlikta apendektomija, plonoji žarna intubuota peroraliniu enterodekompresiniu zondu. Kirmėlinės ataugos histologiniu tyrimu nustatyti antrinio uždegimo požymiai: paviršinis apendicitas ir hemoraginis periapendicitas. Pooperacinis laikotarpis buvo sklandus. Išvada Šis klinikinis atvejis patvirtina, jog galima labai reta komplikacija dėl atipinės kirmėlinės ataugos padėties: klubinės žarnos galinės dalies obstrukcinis užspaudimas kirmėlinės ataugos kilpa. Pagrindiniai žodžiai: apendiksas, atipinė padėtis, klubinės žarnos obstrukcija Strangulated terminal ileal obstruction due to closed-loop appendix Eglė Zakarauskaitė, Raimundas LunevičiusVilnius University, General Surgery Center of Clinic of Gastroenterology,Nephrourology and Surgery, Vilnius University Emergency Hospital,Šiltnamių str. 29, LT-04130 Vilnius, LithuaniaE-mail: [email protected] Objective To describe and estimate a strangulated (by atypical appendix) closed-loop obstruction of the terminal ileum in an adult. Case report 71-year-old male was admitted because of crampy abdominal pain associated with nausea. There was no history of previous intraabdominal operations. On examination, the patient had obvious abdominal distention with peritoneal signs localized in the right iliocecal region. Bowel sounds were decreased. X-ray films showed multiple air fluid levels in the small intestine. Small-bowel obstruction was diagnosed and exploratory laparotomy was performed. The small intestine was heavily dilatated, overflowed by fluids and air because of a vermiform appendix wrapped around the terminal ileum and its mesenterium, and by its tip adhered to the ileocecal recessus. An appendectomy was performed, the small bowel was intubated using an enterodecompressive probe. Histopathology confirmed the diagnosis of secondary superficial appendicitis and hemorrhagic periappendicitis. The convalescence was not delayed. There were no postoperative complications. Conclusions This clinical report shows an unusual but possible very rare complication of atypically located appendix in an adult: a strangulated closed-loop obstruction of the terminal ileum. Key words: appendix, atypical positioning, acute ileal obstruction


2019 ◽  
Vol 12 (8) ◽  
pp. e230419
Author(s):  
Haley Franklin ◽  
Katherine Glosemeyer ◽  
Ali Hassoun

A 39-year-old Caucasian woman presented to the emergency department with worsening abdominal pain, localised to the right lower quadrant, and diarrhoea for a week. Stool tested negative for Clostridium difficile, Giardialamblia and Cryptosporidium. Following an abdominal CT, she was diagnosed with appendicitis. The histological preparation, along with the acute inflammatory changes of the vermiform appendix, was notable for clusters of small, basophilic spherical bodies most consistent with Cryptosporidium parvum infection. Ultimately, the patient was diagnosed with appendicitis secondary to C. parvum infection. This is exceedingly rare and only one other case has been previously reported.


2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Damian Ziaja ◽  
Tomasz Bolkowski ◽  
Krzysztof Januszewski ◽  
Wioletta Skrzypulec-Plinta ◽  
Jerzy Chudek ◽  
...  

Purpose. Appendicular endometriosis mimicking appendicitis is a rare finding. Inguinal tumor in the course of appendicular endometriosis located within an inguinal hernia sac and infiltrating the periosteum of the pubic bone has not yet been described.Case Report. This paper describes a case of a rapidly enlarging, solid, unmovable, very painful upon palpation inguinal tumor, in a 36-year-old nulliparous woman. During surgery, a hard (approximately 4 cm in diameter) tumor infiltrating the periosteum of the right pubic bone and continuous with the inguinal hernia sac was dissected. The distal segment of the vermiform appendix was an element of the dissected tumor. Histological examination revealed endometriosis of the distal vermiform appendix. After 6 months of hormone treatment, she was referred for reoperation due to tumor recurrence. Once again histological examination of the resected tissue revealed endometriosis. There was no further recurrence of the disease with goserelin therapy. In addition to the case report, we present a review of the literature about endometriosis involving the vermiform appendix and the inguinal canal (Amyand’s hernia).Conclusion. This case expands the list of differential diagnoses of nodules found in the inguinal region of women.


2018 ◽  
Vol 159 (19) ◽  
pp. 768-772
Author(s):  
Tamás Vass ◽  
Attila Zaránd ◽  
Dániel Horányi ◽  
László Harsányi

Abstract: Diverticulitis of the vermiform appendix is a rare disease with clinical features often similar to conventional acute appendicitis. The importance of appendiceal diverticulosis is the fact that it can lead to an early and a higher incidence of perforation and therefore a higher mortality rate, in contrast to acute appendicitis alone. In this study we present the clinicopathology, diagnosis and therapy of the disease with a review of the literature. A 65-year-old woman presented to the emergency department with a 48-hour history of intermittent pain in the right iliac fossa. Abdominal ultrasound raised the possibility of acute appendicitis but because of the relative asymptomatic state of the patient, the lack of fever and rebound tenderness we started observation. After 2 days with episodic abdominal pain, the patient was taken to the operating theatre for laparoscopic exploration. Intraoperatively, multiple diverticula were noted on the appendix and appendectomy was performed. Histopathological examination revealed diverticulosis and inflammation of the appendiceal wall. Due to the possible complications, the difficult preoperative diagnosis and its frequent association with appendiceal neoplasm, appendiceal diverticulosis requires special attention. For asymptomatic cases, incidentally diagnosed intraoperatively or discovered by radiology prophylactic appendectomy is recommended. Orv Hetil. 2018; 159(19): 768–772.


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