scholarly journals An unusual reason for an inguinal swelling: De Garengeot’s hernia

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Barbara Sommerhalder ◽  
Reint Burger ◽  
Marco Bueter ◽  
Andreas Thalheimer
Keyword(s):  
Clinical Presentation ◽  
Laparoscopic Approach ◽  
Synthetic Mesh ◽  
Incarcerated Hernia ◽  
Hernia Sac ◽  
Standard Procedures ◽  
Repair Procedure ◽  
Incidental Appendectomy ◽  
Surgical Options ◽  
De Garengeot’S Hernia

Abstract We present the case of a 71-year-old female with an inguinal swelling. Intra-abdominally the appendix was found in a femoral hernia sac (De Garengeot’s hernia). A laparoscopic transabdominal preperitoneal hernia repair procedure was performed with uneventful post-operative course. Clinical presentation of this type of hernia is unspecific and often not to be distinguished from a common incarcerated hernia. Computed tomography can be helpful in obtaining a diagnosis, although the definite diagnosis is mostly found intraoperatively. As surgical options are numerous, there is no consensus on the most suitable one. A laparoscopic approach incorporates the benefit of a total abdominal overview and the possibility of standard procedures. If the appendix appears normal, the use of synthetic mesh is considered safe and an incidental appendectomy is not necessarily required.

scholarly journals P155 DE GARENGEOT HERNIA: A CASE REPORT

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Enrico Ferri ◽  
Melania Claudia Fanelli ◽  
Lorenzo Latham ◽  
Davide Inversini ◽  
Murad Odeh ◽  
...  
Keyword(s):  
Case Report ◽  
Femoral Hernia ◽  
Open Appendectomy ◽  
Rare Type ◽  
Hernia Sac ◽  
The Us ◽  
Direct Hernia ◽  
Surgical Options ◽  
De Garengeot’S Hernia ◽  
De Garengeot Hernia

Abstract Aim “The De Garengeot’s hernia, from Rene De Garengeot, who was the first to describe the appendix inside a femoral hernia sac in 1731, is a rare type of crural hernia. The diagnosis is challenging and surgery must be performed without delay. The incidence of appendicitis in this type of hernia is about 0.08-0.13%. The aim of this work is to describe our experience in the management of this rare subtype of hernia in a 82-year-old women” Material and Methods “A 82-year-old patient with a right groin bulge presented to the Emergency. At the physical examination the abdomen was treatable; there was no sign of bowel obstruction. Blood test values were normal, except for a high PCR value. The US of the groin region demonstrated a right femoral hernia containing a bowel tract, irreducible at the probe’s pressure. The patient underwent surgery, with diagnosis of De Garengeot’s hernia; a direct hernia repair followed by an open appendectomy were performed. The patient did not present any complications and was discharged on the second postoperative day” Results “The De Garengeot hernia is a rare entity that requires an early treatment; the preoperative diagnosis is difficult and often clinical features are similar to a common incarcerated hernia. There are many surgical options for the management of the De Garengeot hernia, but there is not a consensus for the best surgical approach” Conclusions “De Garengeot's hernia is rare, being indistinguishable from an incarcerated femoral hernia in general. This case report is about a De Garengeot’s hernia patient, who presented a good recovery after surgery.”

scholarly journals De Garengeot’s hernia with appendicitis—a rare cause of an acutely painful groin swelling

2019 ◽  
Vol 2019 (5) ◽  
Author(s):  
Adam O’Connor ◽  
Peter Asaad
Keyword(s):  
Acute Appendicitis ◽  
Hernia Repair ◽  
Mesh Repair ◽  
Vermiform Appendix ◽  
Short Review ◽  
Review Of The Literature ◽  
Hernia Sac ◽  
De Garengeot’S Hernia ◽  
De Garengeot Hernia ◽  
Groin Swelling

Abstract De Garengeot hernia is a rare subtype of femoral hernia whereby the vermiform appendix is located within the hernial sac. Even rarer is the presence of appendicitis within the hernia sac. De Garengeot’s hernia is difficult to diagnose pre-operatively and can prove technically difficult at operation particularly with regards to mobilization of the caecum and appendix in order to perform appendicectomy. Laparoscopic, open, with and without mesh repair of de Garengeot hernia have all been described in the literature with varying degrees of success. We present a case of an 82 year old lady presenting with an acutely painful right sided groin lump. CT scan revealed the presence of de Garengeot hernia with acute appendicitis. We describe in text and photo format our approach to the hernia repair, appendicectomy and provide a short review of the literature with regards to the different operative approaches to such a patient.

scholarly journals A Challenging Case of a Physeal Bar Endoscopic-Assisted Resection in a Short Stature Child: Case Report and Literature Review

2021 ◽  
pp. 115-120
Author(s):  
Melanie Ribau ◽  
Mário Baptista ◽  
Nuno Oliveira ◽  
Bruno Direito Santos ◽  
Pedro Varanda ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Short Stature ◽  
Clinical Presentation ◽  
Normal Growth ◽  
Limb Length Discrepancy ◽  
Complete Excision ◽  
Physeal Bar ◽  
Surgical Options ◽  
The Ideal

Partial physeal bars may develop after injury to the growth plate in children, eventually leading to disturbance of normal growth. Clinical presentation, age of the patient, and the anticipated growth will dictate the best treatment strategy. The ideal treatment for a partial physeal bar is complete excision to allow growth resumption by the remaining healthy physis. There are countless surgical options, some technically challenging, that must be weighted according to each case’s particularities. We reviewed the current literature on physeal bars while reporting the challenging case of a short stature child submitted to a femoral physeal bar endoscopic-assisted resection with successful growth resumption. This case dares surgeons to consider all options when treating limb length discrepancy, such as the endoscopic-assisted resection which might offer successful results.

scholarly journals De Garengeot’s hernia - a case of incarcerated femoral hernia with acute gangrenous appendicitis and literature review

2020 ◽  
Vol 73 (7-8) ◽  
pp. 239-244
Author(s):  
Veselin Stanisic ◽  
Miodrag Radunovic ◽  
Miljan Zindovic ◽  
Balsa Stanisic
Keyword(s):  
Literature Review ◽  
Femoral Hernia ◽  
Extensive Literature ◽  
Rare Type ◽  
Hernia Sac ◽  
Urgent Surgery ◽  
Gangrenous Appendicitis ◽  
Defect Repair ◽  
De Garengeot’S Hernia ◽  
Immediate Surgery

Introduction. De Garengeot?s hernia is a rare type of femoral hernia that contains the appendix within the hernia sac and it is found in 0.5-5% of cases. The incidence of appendicitis within the de Garengeot?s hernia is 0.08-0.13%. We present a case of de Garengeot?s hernia with a gangrenous appendicitis and an extensive literature review of published cases. Case Report. We present a case of a 68-year-old woman who underwent urgent surgery due to an incarcerated femoral hernia and preoperatively undiagnosed de Garengeot?s hernia with a gangrenous appendicitis within the femoral hernia sac. Conclusion. De Garengeot?s hernia is most commonly diagnosed intraoperatively and requires immediate surgery in order to avoid complications. There are no recommendations regarding the choice of surgical procedure for femoral defect repair.

scholarly journals Experience of management of abdominal cysts

2020 ◽  
Vol 7 (10) ◽  
pp. 3404
Author(s):  
Dhananjay Vaze ◽  
Pranav Jhadav ◽  
Rajesh M. ◽  
Adarsh Hegde ◽  
Sanjay Raut ◽  
...  
Keyword(s):  
Medical Records ◽  
Clinical Presentation ◽  
Laparoscopic Approach ◽  
Exploratory Laparotomy ◽  
Urachal Cyst ◽  
Duct Cyst ◽  
Clinical Presentations ◽  
Abdominal Masses ◽  
The Common ◽  
Cystic Masses

Benign intra-abdominal cystic masses in children are rare and they have diverse etiopathogenesis, clinical presentation. The present study highlights the experience in the management of benign intra-abdominal cysts pertaining to the diverse etiologies associated with these lesions. The medical records of our hospital between November 2016 to November 2019 were retrospectively reviewed. Patients with cystic abdominal masses were studied with respect to less different clinical presentations, localization of masses, diagnostic tests, surgical aapproaches, histopathological examinations and outcome. Out of the 55 cases, most common lesion was a choledochal cyst. Miscellaneous diagnosis includes an omental cyst, urachal cyst and a pedunculated bile duct cyst. All the cystic lesions of the abdomen need to be considered as close differentials in clinical practice due to the common presentations and similar symptoms produced by these lesions. All the lesions were managed by exploratory laparotomy except two ovarian cysts which were managed with laparoscopic approach.

scholarly journals Brief report: De Garengeot’s hernia

2019 ◽  
Vol 5 (2) ◽  
pp. 9
Author(s):  
M. Hunter Witt ◽  
Adam R. Eppler ◽  
Ahmed M. Mahmoud
Keyword(s):  
Hernia Repair ◽  
Ct Scan ◽  
Laparoscopic Appendectomy ◽  
Amyand’S Hernia ◽  
Femoral Canal ◽  
Blunt Dissection ◽  
Incarcerated Hernia ◽  
De Garengeot’S Hernia ◽  
Open Hernia Repair

We describe a case of a 70-year-old female who presented with pain and swelling in her right groin. CT scan of the abdomen and pelvis found Amyand’s hernia with evidence of inflammation of the appendiceal tip consistent with appendicitis. Laparoscopic appendectomy and open hernia repair revealed an incarcerated hernia. Using blunt dissection, the inflamed tip of the appendix was found in the femoral canal. The appendix was removed. The patient had a De Garengeot’s hernia, not the Amyand’s hernia initially suspected. Patient was discharged home the following day.

scholarly journals Laparoscopic approach for diaphragmatic hernia repair in adult: our experience of four cases

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Abhijeet Kumar ◽  
Ratish Karn ◽  
Bhawani Khanal ◽  
Suresh Prasad Sah ◽  
Rakesh Gupta
Keyword(s):  
Diaphragmatic Hernia ◽  
Clinical Presentation ◽  
Clinical Investigation ◽  
Gastrointestinal Symptoms ◽  
Laparoscopic Approach ◽  
X Ray ◽  
Patch Closure ◽  
Thoracic Approach ◽  
Diaphragmatic Hernias ◽  
Tomography Scan

Abstract Diaphragmatic hernia can be congenital or acquired. Usual clinical presentation may range from asymptomatic cases to serious respiratory/gastrointestinal symptoms and occasionally atypical presentation as lumbar hernia also. The diagnosis of diaphragmatic hernia is based on clinical investigation and is confirmed by plain X-ray film and computed tomography scan. Various treatment approaches, open, laparoscopic and combination, are available for this condition. However, laparoscopic approach has recently gained in popularity. Surgical repair typically involves primary or patch closure of the diaphragm through an open or endoscopic abdominal or thoracic approach. This paper reflects our experience of repair of diaphragmatic hernias to evaluate its safety, efficacy and outcomes.

Obturator Hernia Revisited: Surgical Anatomy, Embryology, Diagnosis, and Technique of Repair

2011 ◽  
Vol 77 (9) ◽  
pp. 1147-1157 ◽  
Author(s):  
Dimitrios Stamatiou ◽  
Lee J. Skandalakis ◽  
Odysseas Zoras ◽  
Petros Mirilas
Keyword(s):  
Correct Diagnosis ◽  
Laparoscopic Approach ◽  
Chronically Ill ◽  
Surgical Anatomy ◽  
Obturator Hernia ◽  
Palpable Mass ◽  
Hernia Sac ◽  
Abdominal Approach ◽  
First Case ◽  
Plain Films

Obturator hernia is the protrusion of intraperitoneal or extraperitoneal organs or tissues through the obturator canal. The first case was published by de Ronsil in 1724. Obturator hernia is more common in older malnourished women due to loss of supporting connective tissue and the wider female pelvis. The hernia sac usually contains small bowel, especially ileum. It may follow the anterior or posterior division of the obturator nerve. In most cases, obturator hernia presents with intestinal obstruction of unknown cause. It may present with obturator neuralgia, as a palpable mass or, in cases of bowel necrosis, as ecchymosis of the thigh. A correct diagnosis is made in 20 to 30 per cent of cases. CT scan is considered the gold standard for diagnosis, whereas ultrasonography, contrast studies, herniography and plain films are less specific. Surgery is the only treatment option for obturator hernia. Hesitancy to intervene surgically for chronically ill patients results in high mortality. Transabdominal approach is indicated in cases of complete bowel obstruction or suspected peritonitis. The extra-abdominal approach is used in preoperatively diagnosed cases and in absence of bowel strangulation. The laparoscopic approach is minimally invasive and effectively reduces morbidity. The defect is closed using sutures, tissue flaps, or prosthetic mesh.

scholarly journals Early outcome of laparoscopic Transabdominal Pre-Peritoneal technique in adult patients with inguinal hernia repair at the Hue Central Hospital - Base 2

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Thanh Xuân Nguyễn ◽  
Đức Anh Lê
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Synthetic Mesh ◽  
Central Hospital ◽  
Incarcerated Hernia ◽  
Strangulated Hernia ◽  
First Choice ◽  
Study Results ◽  
The Mean

Tóm tắt Đặt vấn đề: Thoát vị bẹn là bệnh lý phổ biến trong ngoại khoa, đặc biệt lĩnh vực ngoại tiêu hóa. Từ khi phẫu thuật nội soi ra đời và ứng dụng tấm nhân tạo trong điều trị thoát vị bẹn, đã có những thay đổi trên thế giới về điều trị cho người bệnh thoát vị bẹn. Phương pháp phẫu thuật nội soi đặt tấm nhân tạo đường xuyên phúc mạc TAPP (Trans-Abdominal Pre-Peritoneal) có nhiều ưu điểm như đường cong huấn luyện ngắn, phát hiện thoát vị bẹn đối bên và điều trị cả trường hợp có biến chứng, nên được nhiều phẫu thuật viên trẻ lựa chọn. Phương pháp nghiên cứu: Nghiên cứu tiến cứu, lâm sàng mô tả, theo dõi dọc 19 người bệnh với 21 trường hợp thoát vị bẹn được phẫu thuật TAPP tại Bệnh viện Trung ương Huế - Cơ sở 2 từ tháng 12/2018 đến 3/2019. Kết quả: Tuổi trung bình 66,8 ± 14,35. Thoát vị bẹn nghẹt 4,8%. Thoát vị bẹn cầm tù 9,5%. Thời gian phẫu thuật trung bình một bên 65,3 ± 19,6 phút, hai bên 102,5 ± 12,5 phút. Thời gian hậu phẫu trung bình 4,1 ± 1,6 ngày. Phát hiện 2 trường hợp thoát vị bẹn đối bên. Sau 3 tháng không có trường hợp nào tái phát. Kết luận: Phẫu thuật TAPP là một phẫu thuật an toàn, hiệu quả có thể ứng dụng rộng rãi. Abstract Introduction: Inguinal hernia repair is one of the most common operation performed in general surgery, especially in digestive field. Since the introduction of laparoscopic repair and application of synthetic mesh to treatment, the trends have changed in the last decade in treatment for inguinal hernia. The laparascopic trans-abdominal pre-peritoneal (TAPP) has a short learning cure. TAPP has many advantages, such as wide dissection, contralateral side checkup, treatment strangulated hernia and incarcerated hernia, a short learning cure has been the first choice for surgeons. Materials and Methods: Study subjects included 19 patients with 21 inguinal hernia cases treated by laparoscopic trans-abdominal pre-peritoneal (TAPP) technique at the Hue Central Hospital - Base 2 from 12/2018 though 3/2019. Descriptive and prospective follow-up study. Results: The mean age was 66,8 ± 14,35 years old. Strangulated hernia and incarcerated hernia respectively accounted for 4,8% and 9.5% of cases. The mean durations of unilateral inguinal hernia repair and bilateral inguinal repair were 65,3 ± 19,6 mins and 102,5 ± 12,5 mins, respectively. Mean duration of postoperative stay was 4,1 ± 1,6 days. 2 case (3.2%) with contralateral inguinal hernia were detected. At 3-months evaluation, there was no recurrence. Conclusion: TAPP is a safe and effective surgical technique; should be encouraged and widely applied in different levels hospitals. Keyword: inguinal hernia, TAPP, laparoscopic surgery, mesh.

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