scholarly journals De Garengeot’s Hernia: Two Case Reports with Correct Preoperative Identification of the Vermiform Appendix in the Hernia

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Zhaosheng Jin ◽  
Muhammad Rafiz Imtiaz ◽  
Henry Nnajiuba ◽  
Suzette Samlalsingh ◽  
Akinyede Ojo
Keyword(s):  
Hernia Repair ◽  
Gold Standard ◽  
Femoral Hernia ◽  
Case Reports ◽  
Vermiform Appendix ◽  
Case Control ◽  
Case Control Studies ◽  
Intravenous Contrast ◽  
De Garengeot’S Hernia

We present two cases of incarcerated de Garengeot’s hernia. This anatomical phenomenon is thought to occur in as few as 0.5% of femoral hernia cases and is a rare cause of acute appendicitis. Risk factors include a long pelvic appendix, abnormal embryological bowel rotation, and a large mobile caecum. In earlier reports operative treatment invariably involves simultaneous appendicectomy and femoral hernia repair. Both patients were correctly diagnosed preoperatively with computed tomography (CT). Both had open femoral hernia repair, one with appendectomy and one with the appendix left in situ. Both patients recovered without complications. Routine diagnostic imaging modalities such as ultrasonography and standard CT have previously shown little success in identifying de Garengeot’s hernia preoperatively. We believe this to be the first documented case of CT with concurrent oral and intravenous contrast being used to confidently and correctly diagnose de Garengeot’s hernia prior to surgery. We hope that this case report adds to the growing literature on this condition, which will ultimately allow for more detailed case-control studies and systematic reviews in order to establish gold-standard diagnostic studies and optimal surgical management in future.

scholarly journals Two Rare Cases of Appendicitis: Amyand’s Hernia and De Garengeot’s Hernia

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Kimberly A. Schaaf ◽  
Eric M. Melnychuk ◽  
Ross D. Ellison ◽  
Amy J. Snover
Keyword(s):  
Emergency Department ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Femoral Hernia ◽  
Case Series ◽  
Vermiform Appendix ◽  
Time Frame ◽  
Amyand’S Hernia ◽  
De Garengeot’S Hernia

An Amyand’s hernia is an inguinal hernia that contains vermiform appendix. De Garengeot’s hernias are similar; however, in this case the appendix is within a femoral hernia. Both types of hernia are rare, and those hernias associated with appendicitis, perforation, or abscess are even scarcer presentations. The treatment of Amyand’s hernia and De Garengeot’s hernia is not standardized. Generally, hernia repair is performed but disagreement remains regarding the use of mesh and performing appendectomy. This case series describes two individuals with appendicitis presenting to one emergency department within a 24-hour time frame. One case is of a patient with Amyand’s hernia and another case is a patient with De Garengeot’s hernia with an adjacent abscess. Both individuals were managed with appendectomy and hernia repair without the use of mesh.

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.

A Novel Approach to Managing a Strangulated De Garengeot’s Hernia

2020 ◽  
pp. 000313482094355
Author(s):  
Francis J. Simpson ◽  
Katherine Fay ◽  
Vivian Wang ◽  
David Elwood
Keyword(s):  
Surgical Technique ◽  
Significant Variation ◽  
Case Reports ◽  
Relevant Literature ◽  
Vermiform Appendix ◽  
Open Approach ◽  
Hernia Defect ◽  
Elderly Female ◽  
Novel Approach ◽  
De Garengeot’S Hernia

De Garengeot’s hernia, the presence of an incarcerated vermiform appendix within a femoral hernia, is a rare general surgery emergency that predominantly affects elderly female patients. Due to its rarity, there is significant variation in surgical technique; however, most case reports favor an open approach. Here we present a case of a De Garengeot’s hernia with a unique hybrid open and laparoscopic repair, utilizing the hernia defect as a port site. We will also review the relevant literature.

scholarly journals Sources of bias in signals of pharmaceutical safety in pregnancy

2010 ◽  
Vol 33 (6) ◽  
pp. 349 ◽  
Author(s):  
Gideon Koren ◽  
Sheri Nickel
Keyword(s):  
Null Hypothesis ◽  
Case Reports ◽  
Safety Data ◽  
Case Series ◽  
Case Control ◽  
Recall Bias ◽  
Fetal Exposure ◽  
Case Control Studies ◽  
Fetal Safety ◽  
Pharmaceutical Molecules

Every year scores of new pharmaceuticals enter the market, almost never with human fetal safety data. Such data typically accumulate during the first years of clinical use, in the form of case reports, case series, prospective and retrospective cohorts and case control studies. All of these methods suffer from serious sources of bias, often leading to alarming signals of teratogenicity that are later found to be false. This review highlights major sources of bias, including the bias against the null hypothesis in its different forms, ascertainment and recall bias, in fetal exposure to pharmaceutical molecules.

scholarly journals Gender Differences in Hiccup Patients: Analysis of Published Case Reports and Case-Control Studies

2016 ◽  
Vol 51 (2) ◽  
pp. 278-283 ◽  
Author(s):  
Gyeong-Won Lee ◽  
Rock Bum Kim ◽  
Se Il Go ◽  
Hyun Seop Cho ◽  
Seung Jun Lee ◽  
...  
Keyword(s):  
Gender Differences ◽  
Case Reports ◽  
Case Control ◽  
Case Control Studies

Association between antipsychotic medication and venous thromboembolism

2010 ◽  
Vol 27 (1) ◽  
pp. 22-26
Author(s):  
Santhana Gunasekaran
Keyword(s):  
Venous Thromboembolism ◽  
Observational Studies ◽  
Case Reports ◽  
Case Series ◽  
Case Control ◽  
Case Control Studies ◽  
Antipsychotic Medications ◽  
Strength Of Evidence ◽  
Increased Risk ◽  
Strength Of Association

AbstractObjective: This study aims to identify and review available evidence in the literature to determine the strength of association between antipsychotic medications and thromboembolism as an adverse effect.Method: Electronic databases were searched for evidence.Results: A total of 15 case reports, 14 case series, two observational studies and three case-control studies were found in the literature. Two case control studies found significantly increased risk of venous thromboembolism (OR 13.3 and 7.1 respectively). The risk was high for low potency antipsychotics. Studies were critically appraised to determine the strength of evidence.Conclusion: The studies reviewed indicate a significant association between antipsychotics and venous thromboembolism. Patients using the antipsychotics and those who prescribe them should be aware of this association.

scholarly journals Congenital Hypothyroidism Patients With Thyroid Hormone Receptor Variants Are Not Rare: A Systematic Review

2021 ◽  
Vol 58 ◽  
pp. 004695802110679
Author(s):  
Dong-Zhu Da ◽  
Ye Wang ◽  
Min Wang ◽  
Zhi Long ◽  
Qian Wang ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Congenital Hypothyroidism ◽  
Hormone Receptor ◽  
Thyroid Hormone Receptor ◽  
Case Reports ◽  
Case Control ◽  
Cochrane Library ◽  
Loss Of Function ◽  
Case Control Studies ◽  
Tshr Gene

Background Primary congenital hypothyroidism (CH) is a common endocrine and metabolic disease. Various genetic factors, including the thyroid hormone receptor (TSHR), play an important role in CH. Aim To explore the occurrence of pathogenic TSHR variants in CH. Methods We searched published articles in PubMed, Web of Science, and Cochrane Library databases, from the establishment of the database to September 26, 2021. Studies with sequencing partial or full exons of TSHR in CH patients were included. Gene polymorphism was excluded. Results A total of 66 articles (44 case-control studies and 22 case reports) were selected from the database. Though case-control studies, we found the incidence of pathogenic TSHR variants were not rare (range from 0% to 30.6%) and varied greatly in different countries and race. The pathogenic genotypes varied in different regions. All the variants were “loss-of-function” mutations, in which the p.(Arg450His) variant was the most common variant. In addition, we analyzed the case reports and found that CH patients with a family genetic background expressed homozygous genotypes. Homozygotes had more obvious symptoms of hypothyroidism and higher risk of comorbidities than heterozygotes. Conclusion Pathogenic TSHR variants are not uncommon cause of the CH, especially in the Arabs. The role of TSHR gene detection in the treatment of children with CH needs to be further studied.

scholarly journals Is the Simplicity of the Evidence Pyramid Actually Detrimental for Understanding Evidence?

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Annette O'Connor
Keyword(s):  
Cohort Studies ◽  
Real World ◽  
Disease Risk ◽  
Case Reports ◽  
Meta Analysis ◽  
Information Source ◽  
Case Series ◽  
Case Control ◽  
Current Evidence ◽  
Case Control Studies

The evidence pyramid for assessing the efficacy of interventions under real world conditions has been used in various forms for many years, and to a lesser extent the pyramid has been used for assessing evidence for disease risk factors. While acknowledging minor differences, many pyramids list the following information sources for interventions in decreasing order of “validity”: systematic review and meta-analysis of randomised control trials, randomised controlled trials, cohort studies, case control studies, case series and case reports. The evidence pyramid is often used as a teaching aid to help clinicians and students visualise the concept that all studies might not have equal evidentiary value when evaluating real world efficacy.The rationale for the hierarchy of the pyramid is partially based on the potential for bias in some designs and partially based on the external validity of the information source. Designs with greater potential for bias “on average” are placed lower on the pyramid. The greater risk of bias means a greater risk that effect size estimates from studies lower on the pyramid may be systematically incorrect (overestimated or underestimated). As such, the evidence pyramid makes very broad statements about the design “on average”. Of course, for any particular study or topic, the pyramid may not be correct. Regardless, the generalisations described in the evidence pyramid have over the years been considered useful and use of the tool continues likely because of its simplicity. However, the validity of most pyramids that we have seen (and used ourselves, and published ourselves) is predicated on two potentially false concepts. The first potentially false concept conveyed by most evidence pyramids, is that there is only one case-control design and it is of lesser evidentiary value than cohort studies. The second potentially false concept conveyed by evidence pyramids is that the terms cohort, case control, and case series can be used to “filter” out studies of lower evidentiary value.In this presentation Annette discusses the validity of the evidence pyramid on the interpretation of evidence from primary research. She proposes a new way to think about evidence from primary studies using the framework for classifying epidemiologic studies proposed by Pearce (2012) based on incident and prevalent cases. This would also result in a rethinking of the current evidence pyramid.

Types of trials

2017 ◽  
Author(s):  
Mark Harrison
Keyword(s):  
Emergency Medicine ◽  
Cohort Studies ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Case Control ◽  
Controlled Trials ◽  
Case Control Studies ◽  
Advantages And Disadvantages ◽  
Randomized Controlled

This chapter describes types of trials as applied to Emergency Medicine, and in particular the Primary FRCEM examination. The chapter outlines the key details and advantages and disadvantages of case reports, case series, cohort studies, case–control studies, randomized controlled trials, crossover trials, systematic reviews, and meta-analysis. This chapter is laid out exactly following the RCEM syllabus, to allow easy reference and consolidation of learning.

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