Abdominal wall ectopic testis torsion mimicking a Spigelian hernia in an adult

We report an unusual case of an ectopic testis identified in a 37-year-old man presenting with acute severe right iliac fossa pain and an irreducible mass. Initially diagnosed as a Spigelian hernia, computed tomography and ultrasonography identified the presence of an ectopic testis in the abdominal wall. Interparietal testicular ectopia is an extremely rare condition. We present and discuss the first case in the literature of an ectopic testis located between the internal and external oblique muscle layers of the anterior abdominal wall in an adult.

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An incarcerated Spigelian hernia with the appendix in the sac passing though all layers of the abdominal wall: an unusual cause for chronic right iliac fossa pain

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa099 ◽

2020 ◽

Vol 2020 (6) ◽

Author(s):

Daniel Page ◽

Rasika Hendahewa

Keyword(s):

Chronic Pain ◽

Abdominal Wall ◽

Anterior Abdominal Wall ◽

Iliac Fossa ◽

Spigelian Hernia ◽

Transversus Abdominis ◽

Abdominal Hernias ◽

Right Iliac Fossa Pain ◽

Pass Through ◽

Internal Oblique

ABSTRACT Abdominal wall hernias are a common pathology and source of morbidity including chronic pain. They occur in various anatomical areas; amongst the rarest locations is the Spigelian hernia accounting for <2% of all abdominal hernias. We present a case report of a patient with chronic right iliac fossa pain caused by an incarcerated Spigelian hernia containing her appendix within the hernial defect. Rarer still is that her hernial defect penetrated all three layers of anterior abdominal wall, typically a Spigelian hernia would only pass through transversus abdominis and internal oblique layers.

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A rare case of Spigelian hernia penetrating the external oblique muscle

OA Case Reports ◽

10.13172/2052-0077-2-2-407 ◽

2013 ◽

Vol 2 (2) ◽

Author(s):

T Mariolis-Sapsakos ◽

V Kalles ◽

I Papapanagiotou ◽

A Mekras ◽

K Birbas ◽

...

Keyword(s):

Rare Case ◽

Spigelian Hernia ◽

Oblique Muscle ◽

External Oblique Muscle ◽

External Oblique

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956 Retained Appendiceal Tip and Abdominal Wall Appendicolith - A Rare Combination of Post Appendicectomy Complications

British Journal of Surgery ◽

10.1093/bjs/znab259.343 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

A Dey ◽

N Symons

Keyword(s):

Abdominal Wall ◽

Iliac Fossa ◽

Symptomatic Relief ◽

Radiological Investigation ◽

Complete Excision ◽

Rare Combination ◽

Abdominal Wall Abscess ◽

Right Iliac Fossa Pain ◽

The Right ◽

Inflammatory Changes

Abstract Appendicitis involving the appendix stump is a recognised post appendicectomy complication but the same involving the appendiceal tip is rare. Similarly, abdominal wall abscess secondary to retained appendicolith is also infrequently encountered. Our case highlights a rare combination of both complications arising separately. A 29-year-old man presented with 3 days of generalised malaise and progressively worsening right iliac fossa pain some ten months after a laparoscopic appendicectomy. This had been complicated by residual right iliac fossa inflammation that was treated conservatively and serial scans demonstrated gradually resolving inflammation. He also had well controlled ulcerative colitis. On examination, he was noted to be pyrexial with a tender fluctuant mass in the right flank. An ultrasound scan demonstrated inflammatory changes in the abdominal wall with no intra-abdominal collections. A diagnostic laparoscopy found an inflamed appendix tip, attached to the residual mesoappendix and embedded in the abdominal wall behind the mid-ascending colon. A completion appendicectomy was performed. The patient recovered well but returned 4 months later with persistent pain and a fluctuant mass over the right iliac fossa. Radiological investigation revealed an abdominal wall collection containing a calcified appendicolith. The collection was refractory to ultrasound guided drainage and an exploration of the abdominal wall allowed extraction of the appendicolith followed by symptomatic relief. This case emphasizes the importance of complete excision of the appendix and extraction of debris, which can be challenging when the appendix lies in a retro-colic position.

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External oblique muscle flap for abdominal wall reconstruction: Local solution for local problem

International Journal of Abdominal Wall and Hernia Surgery ◽

10.4103/ijawhs.ijawhs_1_20 ◽

2020 ◽

Vol 3 (2) ◽

pp. 75

Author(s):

Nikhilesh Kumar ◽

Deepsikha Gupta ◽

Debarati Chattopadhyay

Keyword(s):

Abdominal Wall ◽

Abdominal Wall Reconstruction ◽

Muscle Flap ◽

Local Solution ◽

Oblique Muscle ◽

Local Problem ◽

External Oblique Muscle ◽

External Oblique

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External Oblique Muscle Schwannoma: A Rare Anatomical Presentation

Case Reports in Surgery ◽

10.1155/2019/9290821 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Daniel Paramythiotis ◽

Diamantoula Pagkou ◽

Moysis Moysidis ◽

Niki Mantha ◽

Angeliki Cheva ◽

...

Keyword(s):

Abdominal Wall ◽

Surgical Excision ◽

Cystic Mass ◽

Oblique Muscle ◽

Surgical Department ◽

Lateral Abdominal Wall ◽

Benign Schwannoma ◽

First Case ◽

Upper Abdominal ◽

Internal Oblique

Introduction. Schwannomas or neurilemmomas are rare, benign, and usually solitary lesions that arise from the nerve sheath. In the majority of cases, these tumors involve the extremities, head, neck, and trunk. Case Presentation. In the present study, a 52-year-old man presented to our surgical department for the evaluation of a symptomatic lump in his left lateral abdominal wall. CT and MRI confirmed the presence of a cystic mass located between the external and internal oblique muscles. Histopathology and immunohistochemistry confirmed it to be benign schwannoma. Discussion. Schwannomas have rarely been reported in the abdominal wall. To the best of our knowledge, this is the first case of schwannoma located in the left upper abdominal wall and the fifth case of abdominal wall schwannoma reported according to the reviewed medical literature. Conclusion. Benign schwannoma should be included in the differential diagnosis of cystic and symptomatic lesions of the abdominal wall. The treatment of choice is surgical excision, and recurrence is extremely rare.

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Abdominal wall ectopic testis mimicking spigelian hernia

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2010.09.102 ◽

2011 ◽

Vol 46 (2) ◽

pp. 415-416 ◽

Cited By ~ 7

Author(s):

Anand Pandey ◽

Jiledar Rawat ◽

Jigyasa Pandey ◽

Sunita Singh ◽

Saroj Chooramani Gopal

Keyword(s):

Abdominal Wall ◽

Spigelian Hernia ◽

Ectopic Testis

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ABDOMINAL HERNIA AFTER FASCIOTOMY OF THE EXTERNAL OBLIQUE MUSCLE FOR ABDOMINAL WALL CLOSURE IN TRAM SURGERY

Plastic & Reconstructive Surgery ◽

10.1097/00006534-199607000-00041 ◽

1996 ◽

Vol 98 (1) ◽

pp. 182-183

Author(s):

Javier de Elejabeitia González ◽

V. Paloma ◽

J. Sanz ◽

A. Samper ◽

P. Leniz ◽

...

Keyword(s):

Abdominal Wall ◽

Abdominal Hernia ◽

Oblique Muscle ◽

Abdominal Wall Closure ◽

External Oblique Muscle ◽

External Oblique

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Case Report: Intussepting mucocele appendix

F1000Research ◽

10.12688/f1000research.18201.1 ◽

2019 ◽

Vol 8 ◽

pp. 1939

Author(s):

Tom Crawley-Smith

Keyword(s):

Case Report ◽

Iliac Fossa ◽

Rare Condition ◽

Operative Management ◽

Right Hemicolectomy ◽

Malignant Potential ◽

Rare Presentation ◽

Mucocele Of The Appendix ◽

Right Iliac Fossa Pain

Background: A case study of a presentation of a mucocele appendix, a rare condition accounting for 0.2% of appendicectomies. The case and operative management are discussed along with the possible progression to pseudomyxoma peritoneii and its differing management. Case: A 15-year-old girl had two presentations with atypical Right Iliac Fossa pain over 2 months. This was investigated with ultrasound and CT which revealed a calcified, intussusepting mucocele of the appendix. This was surgically resected with partial Right Hemicolectomy. The patient was discharged on day 3 with no complications. Discussion: The presentation, malignant potential, investigation and management of the mucocele appendix are discussed. The rare presentation of a mucocele appendix necessitates care to eliminate the risk of pseudomyxoma peritoneii. The operative management should minimise disturbance of the peritoneum in this presentation. In this case, due to an intersussepting nature a limited Right Hemicolectomy had to be performed. This is compared to the literature.

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