Amyand Hernia in a Pediatric Patient With Acute Perforated Appendicitis Undergoing Laparoscopy: A Brief Report and Literature Review

2021 ◽  
pp. 000313482110385
Author(s):  
Ryan M. Huttinger ◽  
Elizabeth M. Sawyer
Keyword(s):  
Recent Literature ◽  
Inguinal Canal ◽  
Perforated Appendicitis ◽  
Vermiform Appendix ◽  
Rare Entity ◽  
Rare Presentation ◽  
Abdominal Hernias ◽  
Inguinal Hernias ◽  
Amyand Hernia ◽  
Pediatric Populations

An 8-year-old male presented for evaluation of symptoms consistent with appendicitis. Upon laparoscopy, the patient was found to have appendicitis with a concomitant Amyand hernia. The latter pathology highlights a rare presentation of inguinal hernias in which the vermiform appendix herniates into the inguinal canal. Inguinal hernias are frequently encountered in pediatric populations; however, Amyand hernias have seemingly negligible incidence in all age demographics. These comprise roughly 1% of all diagnosed abdominal hernias. When seen in concurrence with appendicitis, the incidence is 0.13%. Recent literature has sought to classify types of Amyand hernias and criteria described by Losanoff and Basson is an attempt to guide surgical management. Although our management did not coincide with the proposed management above, the patient made a full recovery. In conclusion, Amyand hernias remain a rare entity that can be indistinguishable from routine inguinal hernias on clinical examination and management of Amyand hernia with appendicitis is not well defined.

scholarly journals Incarcerated Amyand’s Hernia with Destructive Appendicitis Complicated with Myocardial Infarction. A Case Report and Review of the Literature.

2021 ◽  
Vol 5 (1) ◽  
pp. 803-805
Author(s):  
Dimitar Hadzhiev ◽  
Dzhevdet Chakarov ◽  
Evgeniy Moshekov ◽  
Boris Sakakushev ◽  
Elena Hadzhieva
Keyword(s):  
Hernia Repair ◽  
Recurrent Hernia ◽  
Abdominal Sepsis ◽  
Amyand’S Hernia ◽  
Rare Presentation ◽  
Rare Type ◽  
Hernia Sac ◽  
Inflammatory Status ◽  
Inguinal Hernias ◽  
Amyand Hernia

Amyand hernia is a rare presentation in inguinal hernias (less than 1% of cases with inguinal hernias) which is evidenced when in herniated masses the presence of inflamed appendix is ​​ascertained or not. It was named after a French surgeon, Claudius Amyand (1660-1740), who performed the first successful appendectomy in 1735, where he found an acute appendicitis in a herniated mass. Most cases are diagnosed intraoperatively, as an accurate preoperative diagnosis rarely becomes evident. Management is individual depending on the stage of inflammation of the appendix, the presence of abdominal sepsis and concomitant factors. The decision should be based on factors such as the patient's age, the size and anatomopathological shape of the appendix, and in the case of an inflamed appendix, standard appendectomy and retinal herniorrhage should be the gold standard of treatment. Amyand hernia is usually misinterpreted as a common incarcerata hernia. Symptoms that mimic appendicitis may appear. Treatment consists of a combination of appendectomy and hernia repair. The inflammatory status of the appendix determines the type of hernia repair and the surgical technique. Occasional appendectomy in the case of a normal appendix is ​​not recommended. Amyand hernia is a rare type of inguinal hernia in which the appendix is located in the hernia sac. We present a case of a recurrent incarcerated Amyand’s hernia with complicated appendicitis. The 78 old polymorbide patient with right-sided incarcerated recurrent hernia was emergently operated on and appendectomy and non-mesh hernioplasty performed, on the 3rd postoperative day for a heart attack he was placed cardio stimulator with uneventful outcome. Fifteen months follow up did not show complications or complaints.

scholarly journals Multiple Koenen Tumors, a Rare Entity: Combination Treatment with 1% Topical Sirolimus Electrofulguration and Excision

2020 ◽  
Vol 7 (1) ◽  
pp. 66-70
Author(s):  
Vishalakshi Viswanath ◽  
Jay D. Gupte ◽  
Niharika Prabhu ◽  
Nilima L. Gour
Keyword(s):  
Tuberous Sclerosis ◽  
Combination Treatment ◽  
Tumor Regression ◽  
Surgical Excision ◽  
Tumor Formation ◽  
Rare Entity ◽  
Rare Presentation ◽  
Cutaneous Manifestations ◽  
Elderly Female

<b><i>Introduction:</i></b> Koenen tumors are benign, cutaneous manifestations of tuberous sclerosis. These are disfiguring, painful, and challenging to treat as they frequently recur. We report a case of long-standing, multiple Koenen tumors affecting all twenty nails in an elderly female who was successfully treated with a combination of topical sirolimus 1%, surgical excision, and electrofulguration. <b><i>Case Report:</i></b> A 57-year-old lady presented with multiple, asymptomatic periungual, and subungual tumors affecting all twenty nails since 27 years. Cutaneous examination revealed confetti macules, ash-leaf macule, and shagreen patch over trunk. Nail biopsy was compatible with Koenen’s tumor. Computerized tomography of brain showed diffuse patchy sclerosis. The tumors were treated with topical sirolimus 1% ointment for 10 months with excellent regression. Electro­fulguration for both great toenails and surgical excision of right thumbnail periungual fibroma was done. 1% sirolimus was advised after the surgical treatment. There were no adverse effects or recurrence of tumors over a 2-year follow-up. <b><i>Discussion:</i></b> Topical sirolimus 1% was effective in tumor regression and preventing new tumor formation. Larger tumors that interfered in daily chores were treated with excision and electrofulguration. Thus, a combination treatment for this rare presentation of tuberous sclerosis provided optimum results.

scholarly journals Type 4 appendiceal diverticulum within a de Garengeot hernia

2016 ◽  
Vol 98 (7) ◽  
pp. e141-e142 ◽  
Author(s):  
SH Rossi ◽  
E Coveney
Keyword(s):  
Femoral Hernia ◽  
Cystic Lesion ◽  
Vermiform Appendix ◽  
Clinical Suspicion ◽  
Intraluminal Pressure ◽  
Rare Entity ◽  
History Of ◽  
The Right ◽  
De Garengeot Hernia ◽  
Learning Points

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.

On the question of the use of a prolapsed uterus in plastic surgery of an inguinal hernia in women

1926 ◽  
Vol 22 (5-6) ◽  
pp. 690-692
Author(s):  
N. I. Kedrova
Keyword(s):  
Inguinal Hernia ◽  
Plastic Surgery ◽  
Abdominal Hernias ◽  
Inguinal Hernias ◽  
Straight Line ◽  
Similar Combination

Being, according to the latest views, one of the manifestations of the general ptotic constitution, prolapse of the uterus, which, according to Halban and Tandler, is also a kind of hernia, of course, can occur in combination with other abdominal hernias. In 285 patients I operated on for prolapse of the uterus, I met a similar combination in 12 cases, and in 4 of them there were umbilical hernias, in 1 - a hernia of a straight line of the abdomen and in 7 - inguinal hernias, among which 3 required plastic surgery.

scholarly journals Carcinoma of Vagina in Utero-Vaginal Prolapse: A Rare Presentation

2012 ◽  
Vol 52 (186) ◽  
Author(s):  
S Acharya ◽  
DK Uprety
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Histopathological Examination ◽  
Large Cell ◽  
Uterovaginal Prolapse ◽  
Rare Entity ◽  
Rare Presentation ◽  
Vaginal Carcinoma ◽  
Keywords Squamous Cell Carcinoma

Primary vaginal carcinoma in uterovaginal prolapse is a rare entity. We report a case of an 84-years-old lady, who presented with long standing vaginal ulcer in association with third degree uterovaginal prolapse. Incisional biopsy was taken from the ulcer. Histopathological examination showed a large cell keratinizing squamous cell carcinoma. Keywords: Squamous cell carcinoma, uterovaginal prolapse, vaginal carcinoma.

scholarly journals Emergency surgical management of sub-hepatic appendicular perforation with abscess; rare presentation of a common disease: a case report

2021 ◽  
Vol 9 (11) ◽  
pp. 3478
Author(s):  
S. K. Sekendar Ali ◽  
Narendra Nath Mukhopadhyay
Keyword(s):  
Case Report ◽  
Surgical Management ◽  
Perforated Appendicitis ◽  
Exploratory Laparotomy ◽  
Clinical Suspicion ◽  
Common Disease ◽  
Emergency Setting ◽  
Atypical Presentation ◽  
Rare Presentation ◽  
High Level

Subhepatic appendicitis is a very rare presentation that has been rarely reported, accounting for 0.01% of acute appendicitis case. It is difficult to diagnose and prime to be aware of variants, manage such challenging case in emergency setting. We present a case of 29 years male patient with subhepatic perforated appendicitis and its sequelae-abscess and peritonitis who underwent an exploratory laparotomy and appendectomy. The initial diagnosis and surgical management of such patients is challenging due to very rare and atypical presentation in emergency setting. A high level of clinical suspicion, promote decision to operate and skillful surgical approach is discussed with briefly.

scholarly journals Solitary Angiokeratoma of Oral Mucosa: A Rare Presentation

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Shilpa Kandalgaonkar ◽  
Suyog Tupsakhare ◽  
Ashok Patil ◽  
Gaurav Agrawal ◽  
Mahesh Gabhane ◽  
...  
Keyword(s):  
Oral Mucosa ◽  
Papillary Dermis ◽  
Common Denominator ◽  
Rare Entity ◽  
Epidermal Hyperplasia ◽  
Rare Presentation ◽  
Female Predominance ◽  
Mucosal Involvement ◽  
Chronic Irritation ◽  
Oral Involvement

Solitary angiokeratoma of oral mucosa is rare entity. The term Angiokeratoma is used to refer to several lesions, whose common denominator is the presence of dilated blood vessels in association with epidermal hyperplasia. Mucosal involvement, including oral cavity is occasionally found either as a component of the systemic variety, cutaneous involvement or isolated oral involvement. Clinically, the lesion is irregular, whitish to dark brown in color, with female predominance. The etiological factors include injury, trauma, or chronic irritation to the wall of a papillary dermis. Histologically, it is characterized by hyperkeratosis, acanthosis, and dilated vascular spaces with or without organizing thrombi in papillary dermis. The vascular spaces are partly or completely enclosed by elongated ret-ridges. Along with this reporting a case of solitary angiokeratoma affecting tongue in a 38-year-old male patient, along with the literature review is presented.

Adrenal pheochromocytoma with involvement of aorta and left renal artery: salvaged with adrenalectomy and nephrectomy

2021 ◽  
Vol 14 (9) ◽  
pp. e244297
Author(s):  
Shekhar Sathaye ◽  
Kalpesh Mahesh Parmar ◽  
Santosh Kumar ◽  
Pulkit Rastogi
Keyword(s):  
Renal Artery ◽  
Renal Involvement ◽  
Renal Tissue ◽  
Preoperative Imaging ◽  
Beta Blockade ◽  
Left Renal Artery ◽  
Rare Entity ◽  
Rare Presentation ◽  
Adrenal Pheochromocytoma

Large adrenal pheochromocytomas encasing the renal artery are a rare entity. The management of such challenging cases is surgical resection. The involvement of renal tissue and renal artery may necessitate meticulous dissection and concomitant nephrectomy. Here, we present a case of 41-year-old man diagnosed with left adrenal pheochromocytoma with complete encasement of left renal artery and partial encasement of aorta. Open left adrenalectomy and nephrectomy was performed after adequate preoperative optimisation. The patient is doing well at 6-month follow-up. Large adrenal pheochromocytoma with renal involvement is a rare presentation and requires optimal preoperative imaging, adequate preoperative alpha and beta blockade and meticulous surgical technique.

9 CASES OF AMYAND’S HERNIA IN CHILDREN

2021 ◽  
pp. 118-123
Author(s):  
M.KH. MALIKOV ◽  
◽  
F.SH. RASHIDOV ◽  
F.B. BOKIEV ◽  
F.M. KHAMIDOV ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Postoperative Period ◽  
Inguinal Canal ◽  
Posterior Wall ◽  
Vermiform Appendix ◽  
Greater Omentum ◽  
Amyand’S Hernia ◽  
Inguinoscrotal Hernia ◽  
Hernial Sac

9 children aged 4 to 14 years underwent a right-sided inguinal hernia repair, at the same time, a vermiform appendix was found in the hernial sac. All patients were hospitalized with a diagnosis of «Congenital right-sided inguinoscrotal hernia», bilateral hernias were not observed. Objectively, there were all signs of the disease, all hernias were reducible. The presence of the appendix in the hernial sac before the operation was not diagnosed either clinically or by ultrasound. The contents of the hernial sac had a thickened and long vermiform appendix, a greater omentum, and in two cases – a cecum of the type of sliding hernia. The children were operated on under general anesthesia: appendectomy and plastic surgery of posterior wall of inguinal canal were performed. No complications were observed in the postoperative period.

Surgical treatment of inguinal hernia in childhood

1927 ◽  
Vol 23 (9) ◽  
pp. 972-972
Author(s):  
I. Tsimkhes
Keyword(s):  
Early Childhood ◽  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Inguinal Canal ◽  
Older Children ◽  
Processus Vaginalis ◽  
Hernia Sac ◽  
Absolute Certainty ◽  
Inguinal Hernias

The author finds that the number of inguinal hernias in early childhood, due to incomplete overgrowth of the processus vaginalis peritonei, greatly prevails over the number of the same in older children. Some of these hernias heal spontaneously due to overgrowth of proc. vaginalis and lengthening of the inguinal canal itself. Bandage treatment, even in the most cultured setting, cannot guarantee with absolute certainty the budding of the hernia sac.

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