Left Amyand’s hernia with inflamed appendix and sealed of perforated caecum an unusual case

Amyand’s hernia is defined as the hernia with appendix normal, inflamed or perforated as content. 1% of inguinal hernias are Amyand’s and amongst them 0.1% contains inflamed appendix. Commonly encountered on right size due to anatomical position of appendix. Left Amyand’s is rare and associated with intestinal malrotation, situs invertus and mobile caecum. Here, we presented an interesting case of left irreducible hernia in 70 years old gentleman with no signs of acute obstruction or strangulation, patient underwent emergency laparotomy in which hernial sac contents were inflamed ileal loop, inflamed appendix and perforated caecum in 70 years old man is rare presentation and not reported in any literature as per our knowledge. Resection of inflamed bowel loop with ceacum done along with ileo ascending anastomosis with primary tissue repair done. Post-operative period was uneventful. Hernia sac contents are most of the time surprising and their management sometimes differ according to the content. Appendix in hernia sac is found in 1% of all hernia but lack of facility for the pre-operative diagnosis and varied presentation it is challenging to diagnose and operate accordingly.

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

Albanian Journal of Trauma and Emergency Surgery ◽

10.32391/ajtes.v5i1.164 ◽

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.

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Jejunal Perforation: A Rare Presentation of Burkitt’s Lymphoma—Successful Management

Case Reports in Oncological Medicine ◽

10.1155/2014/538359 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Samir Ranjan Nayak ◽

Ganni Bhaskara Rao ◽

Subramanya Sarma Yerraguntla ◽

Sisir Bodepudi

Keyword(s):

Malignant Tumors ◽

Burkitt’S Lymphoma ◽

High Dose Chemotherapy ◽

Interesting Case ◽

Burkitt's Lymphoma ◽

Emergency Laparotomy ◽

High Dose ◽

Successful Management ◽

Rare Presentation ◽

Uncommon Presentation

Malignant tumors of the small bowel presenting as acute abdomen are a rare occurrence. Burkitt’s lymphoma presenting as a surgical emergency needing emergency laparotomy is an uncommon presentation of this tumor. We present an interesting case of jejunal perforation as a first manifestation of Burkitt’s lymphoma which was successfully managed with surgical resection, high dose chemotherapy, and good supportive care.

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Amyand’s Hernia Presenting as a Scrotal Abscess – A Rare Presentation in a Newborn

Surgical Case Reports ◽

10.31487/j.scr.2021.02.21 ◽

2021 ◽

pp. 1-3

Author(s):

Prakash Agarwal ◽

Vadyala Akshita Reddy ◽

Prakash Agarwal ◽

Madhu Ramasundaram ◽

Jegadeesh Sundaram ◽

...

Keyword(s):

Inguinal Hernia ◽

Newborn Infants ◽

Amyand’S Hernia ◽

Bowel Loop ◽

Bilateral Inguinal Hernia ◽

Rare Presentation ◽

Intravenous Antibiotics ◽

Perforated Appendix ◽

Scrotal Swelling ◽

The Right

A 26-week-old extreme preterm boy presented with a right hemiscrotal abscess. An ultrasound of the scrotum suggested right epididymo-orchitis. The abscess was drained and appropriate intravenous antibiotics were initiated. One month later, he was diagnosed with a right sided irreducible inguino-scrotal swelling, confirmed as bilateral inguinal hernia with herniating bowel loop on ultrasonography. With this diagnosis, he was planned to undergo a bilateral herniotomy. Intraoperatively, an inflamed and perforated appendix was found herniating into the right sac. The tip of the appendix was adherent to the scrotal wall, where the pus was extruding out. Appendicectomy and bilateral herniotomy was done successfully and histopathology revealed acute appendicitis. Baby recovered well postoperatively. Owing to the fragile nature of tissues in neonates, accession of planes was challenging. Amyand’s hernia presenting as a scrotal abscess is extremely rare in newborn infants, and less than 5 cases have been reported till date.

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Rare case of paracaecal hernia with intussusception presenting as small bowel obstruction: case report

International Surgery Journal ◽

10.18203/2349-2902.isj20201890 ◽

2020 ◽

Vol 7 (5) ◽

pp. 1662

Author(s):

M. S. Kalyan Kumar ◽

Shyamsundar R. ◽

Sabari Girieasan M. ◽

R. Kannan ◽

S. Nedunchezhiyan

Keyword(s):

Intestinal Obstruction ◽

Internal Hernia ◽

Exploratory Laparotomy ◽

Acute Intestinal Obstruction ◽

Emergency Laparotomy ◽

High Morbidity ◽

Rare Presentation ◽

Ileal Loop ◽

Rare Type ◽

Internal Hernias

Primary internal hernias are very rare in adults. They are an unusual cause of small intestinal obstruction and lead to high morbidity and mortality if left untreated. Clinical presentation of internal hernia is highly nonspecific. Imaging has limited role in diagnosing the cause of acute intestinal obstruction. Internal hernias are usually detected at laparotomy. We report a case of a 61-year-old male who presented with acute intestinal obstruction which was attributed later to a very rare type of internal hernia on exploratory laparotomy. A loop of ileum was found to enter the retroperitoneum through a hernia gate which was located lateral to the caecum and ileo ileal intussusception was noted proximal to the herniated loop. The segment of intestine was resected and anastamosed then hernial defect was closed. Paracaecal hernias are the rare type of hernias in internal hernia. In our case, intussusception was noted proximal to the herniated ileal loop which is a very rare presentation. Intussusception was reported previously with paraduodenal type. One should always keep in mind while conducting emergency laparotomy, internal hernias can be a cause for intestinal obstruction.

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A Rare Presentation of Maydl’s Hernia

Case Reports in Surgery ◽

10.1155/2014/184873 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3

Author(s):

Elroy Patrick Weledji ◽

Martin Mokake ◽

Marcelin Ngowe Ngowe

Keyword(s):

Inguinal Hernia ◽

Indirect Inguinal Hernia ◽

Strangulated Hernia ◽

Rare Presentation ◽

Ileal Loop ◽

Hernia Sac ◽

Operative Findings ◽

Maydl's Hernia

We present a case of an unsual type of obstructed indirect inguinal hernia with impending strangulation. The operative findings revealed a sliding Maydl’s hernia with an ischemic inner ileal loop and an adherent inflamed appendix. This case highlights the importance of intraoperative examination of the intra-abdominal bowel loops proximal to the hernia sac of an incarcerated, obstructed, or strangulated hernia.

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Faecopneumothorax due to missing diaphragmatic hernia: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-020-02606-3 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Resul Nusretoğlu ◽

Yunus Dönder

Keyword(s):

Computed Tomography ◽

Diaphragmatic Hernia ◽

Colon Resection ◽

Emergency Laparotomy ◽

Hernia Sac ◽

Case Presentation ◽

Abdominal Tenderness ◽

History Of ◽

Diaphragmatic Hernias ◽

Tomography Scan

Abstract Background Diaphragmatic hernias may occur as either congenital or acquired. The most important cause of acquired diaphragmatic hernias is trauma, and the trauma can be due to blunt or penetrating injury. Diaphragmatic hernia may rarely be seen after thoracoabdominal trauma. Case presentation A 54-year-old Turkish male patient admitted to the emergency department with abdominal pain and dyspnea ongoing for 2 days. He had general abdominal tenderness in all quadrants. He had a history of a stabbing incident in his left subcostal region 3 months ago without any pathological findings in thoracoabdominal computed tomography scan. New thoracoabdominal computed tomography showed a diaphragmatic hernia and fluid in the hernia sac. Due to respiratory distress and general abdominal tenderness, the decision to perform an emergency laparotomy was made. There was a 6 cm defect in the diaphragm. There were also necrotic fluids and stool in the hernia sac in the thorax colon resection, and an anastomosis was performed. The defect in the diaphragm was sutured. The oral regimen was started, and when it was tolerated, the regimen was gradually increased. The patient was discharged on the postoperative 11th day. Conclusions Acquired diaphragmatic hernia may be asymptomatic or may present with complications leading to sepsis. In this report, acquired diaphragmatic hernia and associated colonic perforation of a patient with a history of stab wounds was presented.

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Isolated multidrug-resistant tubercular tenosynovitis of the flexor tendon of the little finger

BMJ Case Reports ◽

10.1136/bcr-2020-238339 ◽

2021 ◽

Vol 14 (2) ◽

pp. e238339

Author(s):

Sunny Chaudhary ◽

Subhajit Maji ◽

Varun Garg ◽

Vivek Singh

Keyword(s):

Flexor Tendon ◽

Extrapulmonary Tuberculosis ◽

Functional Limitation ◽

Clinical Signs ◽

Multidrug Resistant ◽

Interesting Case ◽

Antitubercular Therapy ◽

Histopathological Diagnosis ◽

Rare Presentation ◽

Little Finger

Isolated multidrug-resistant (MDR) tubercular tenosynovitis of the flexor tendons of finger without involvement of wrist is a rare presentation. Tenosynovitis of hand is an uncommon manifestation of extrapulmonary tuberculosis. Pyogenic flexor tenosynovitis of hand is frequently seen and is the closest differential. Non-specific clinical signs may lead to delay in diagnosis, which is often made after biopsy. Management includes surgical excision of necrotic tissue and infected synovium along with antitubercular therapy after histopathological diagnosis. MDR tuberculosis of hand is extremely rare and, to the best of our knowledge, has not been reported in the literature so far. We report an interesting case of MDR tubercular flexor tendon tenosynovitis of the little finger without any pulmonary involvement in an immunocompetent patient. The case was managed by complete synovectomy and second-line antitubercular therapy with complete resolution of disease and had no functional limitation.

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Unusual case of hyperemesis in a pregnant patient with prior antireflux surgery

BMJ Case Reports ◽

10.1136/bcr-2021-241935 ◽

2021 ◽

Vol 14 (8) ◽

pp. e241935

Author(s):

Abimbola Obisesan ◽

Eleanor Lucy Townsend ◽

John Lin Hieng Wong ◽

Vinod Menon

Keyword(s):

Decision Making ◽

Abdominal Pain ◽

Antireflux Surgery ◽

Unusual Case ◽

Nissen Fundoplication ◽

Hyperemesis Gravidarum ◽

Pregnant Patient ◽

Emergency Laparotomy ◽

Laparoscopic Nissen ◽

Upper Abdominal

A 33-year-old, 8 weeks pregnant, presented with severe upper abdominal pain with vomiting on a background of a previous laparoscopic Nissen fundoplication for reflux disease. An urgent MRI had shown herniation of the fundoplication wrap through the diaphragmatic hiatus. The cause of her symptoms was attributed to hyperemesis gravidarum. The plan was to manage this patient conservatively until the conclusion of her pregnancy. This plan was revised when she presented for the second time and developed worsening pain and haematemesis. An emergency gastroscopy showed ischaemic changes in most of the stomach requiring the patient to undergo an emergency laparotomy. In pregnant patients, presenting with abdominal pain, vomiting as well as haematemesis, having had previous antireflux surgery, incarceration of the stomach must be considered as a differential. Prompt assessment and early senior decision-making is extremely important in avoiding a potentially catastrophic outcome for such patients.

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