Complex de Garengeot’s Hernia With a Bladder Diverticulum

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.

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An elderly male with lower urinary tract symptoms during COVID-19 pandemic: Extraperitoneal perforation of bladder diverticulum

Urologia Journal ◽

10.1177/03915603211022945 ◽

2021 ◽

pp. 039156032110229

Author(s):

Amit Sharma ◽

Deepak Biswal ◽

Satyadeo Sharma ◽

Siddhant Roy

Keyword(s):

Bladder Outlet Obstruction ◽

Outlet Obstruction ◽

Transurethral Resection Of Prostate ◽

Bladder Diverticulum ◽

Elderly Male ◽

Bladder Drainage ◽

Intravenous Antibiotics ◽

Urinary Tract Symptoms ◽

Lower Urinary

Case: We present a case of spontaneous extra-peritoneal rupture of an acquired diverticulum an elderly male with symptoms of bladder outlet obstruction who presented in emergency with acute abdomen. Outcome: The acute phase was managed conservatively with bladder drainage and intravenous antibiotics. He recently underwent Transurethral Resection of Prostate. He is asymptomatic on follow-up. Conclusions: Acquired bladder diverticulum are rare in adults and are mostly seen in patients with high pressure bladder due to bladder outlet obstruction. Atraumatic extraperitoneal ruptures of diverticulum are uncommonly reported.

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Bladder Diverticulum: Clinicopathologic Spectrum in Pediatric Patients

Pediatric and Developmental Pathology ◽

10.2350/12-02-1154-oa.1 ◽

2012 ◽

Vol 15 (4) ◽

pp. 281-285 ◽

Cited By ~ 15

Author(s):

Riley E. Alexander ◽

Jennifer B. Kum ◽

Muhammad Idrees

Keyword(s):

Pediatric Patients ◽

Bladder Diverticulum

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A Carcinosarcoma/Sarcomatoid Carcinoma Arising in a Urinary Bladder Diverticulum

Archives of Pathology & Laboratory Medicine ◽

10.5858/2002-126-0853-acscai ◽

2002 ◽

Vol 126 (7) ◽

pp. 853-855 ◽

Cited By ~ 1

Author(s):

Atilla Omeroglu ◽

Gladell P. Paner ◽

Eva M. Wojcik ◽

Kalliopi Siziopikou

Keyword(s):

Urinary Bladder ◽

Sarcomatoid Carcinoma ◽

High Grade ◽

Bladder Diverticulum ◽

Unusual Site ◽

Muscular Layer ◽

Spindle Cells ◽

Aggressive Tumor ◽

Glandular Structures ◽

Pleomorphic Cells

Abstract We describe an invasive polypoid carcinosarcoma/sarcomatoid carcinoma arising within a urinary bladder diverticulum in a 65-year-old patient with synchronous, moderately differentiated prostatic adenocarcinoma. Histologically, the diverticular tumor exhibits an admixture of different morphologic components, including invasive high-grade urothelial carcinoma, malignant glandular structures in a cellular background of malignant spindle cells, and areas formed exclusively by spindle and pleomorphic cells. There was full-thickness involvement of the diverticulum with extension of the tumor into the perivesical fat and ipsilateral seminal vesicle. In view of the early invasive behavior of carcinosarcoma/sarcomatoid carcinoma combined with the paucity of the muscular layer in the diverticulum wall, a graver prognosis was expected for this aggressive tumor that occurred in this unusual site.

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Treatment of de Garengeot’s hernia: a meta-analysis

Hernia ◽

10.1007/s10029-018-1862-5 ◽

2018 ◽

Vol 23 (1) ◽

pp. 131-141 ◽

Cited By ~ 7

Author(s):

S. Linder ◽

G. Linder ◽

C. Månsson

Keyword(s):

Meta Analysis ◽

De Garengeot’S Hernia

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Laparoscopic Excision of a Giant Bladder Diverticulum

Korean Journal of Urology ◽

10.4111/kju.2008.49.4.379 ◽

2008 ◽

Vol 49 (4) ◽

pp. 379

Author(s):

Sun Wook Kim ◽

Jin-Woo Jung ◽

Hyuk Jin Cho ◽

Joon Chul Kim ◽

Tae-Kon Hwang ◽

...

Keyword(s):

Bladder Diverticulum ◽

Laparoscopic Excision

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Congenital bladder diverticulum in a child: Surgical steps of extra-vesical excision

Urology Case Reports ◽

10.1016/j.eucr.2018.10.009 ◽

2019 ◽

Vol 22 ◽

pp. 42-43 ◽

Cited By ~ 1

Author(s):

R.B. Nerli ◽

Shridhar C. Ghagane ◽

Abhijit Musale ◽

Sushant Deole ◽

Murigendra B. Hiremath ◽

...

Keyword(s):

Bladder Diverticulum

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Extravesical diverticulectomy: A surgical technique for managing a giant bladder diverticulum

Vojnosanitetski pregled ◽

10.2298/vsp0705349m ◽

2007 ◽

Vol 64 (5) ◽

pp. 349-352 ◽

Cited By ~ 1

Author(s):

Novak Milovic ◽

Vladimir Bancevic

Keyword(s):

Lower Urinary Tract ◽

Urinary Infection ◽

Intravenous Urography ◽

Bladder Diverticulum ◽

Special Group ◽

Urine Retention ◽

The Third ◽

Voiding Symptoms ◽

Urinary Tract Symptoms ◽

Lower Urinary

Background. Bladder diverticulum may be congenital and acquired. Iatrogenic bladder diverticulum is classified in a special group. Indications for surgery are: persistent or recurrent urinary infection, the presence of a stone in a diverticulum, development of tumor in a diverticulum cavity, the lower urinary tract symptoms and voiding symptoms and vesicoureteral reflux due to diverticulum or ureteral obstruction. Case report. We presented a patient with a giant bladder diverticulum. Transurethral bladder catheterisation was performed because of urine retention. Secondly, transurethral prostate resection solved subvesical obstruction. The third step was open, extravesical diverticulectomy. Post-operative course was without complications. Three months after the surgery, control intravenous urography revealed normal findings. Conclusion. We believe that the three-steps treatment of a giant bladder diverticulum significatntly contributed to the decreasing of postoperative complications. .

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