METHODS: A 59-year-old man was admitted to the hospital with a painful right inguinal mass that had suddenly developed 6 hours earlier. Physical examination revealed a 4 cm × 2 cm palpable mass in the right groin. The mass was hard and could not be reduced due to tenderness. It did not descend into the scrotum. B-ultrasound revealed an incarcerated hernia. During surgery, the hernia was found to contain the appendix, which exhibited distal avascular necrosis. A De Garengeot hernia was diagnosed according to the classification criteria of this type of inguinal hernia. Laparoscopic reduction of the incarcerated hernia, appendectomy, and small-incision femoral hernia repair were performed in the emergency department, and cefuroxime was administered as anti-infection therapy for 2 d postoperatively. After treatment, the patient had no abdominal pain or infection and was discharged on postoperative day 4. He had no recurrence of the inguinal hernia after 16 months of follow-up.
CONCLUSIONS: De Garengeot hernias have a low incidence and are difficult to diagnose. Laparoscopy is useful for their diagnosis and treatment.
方法:一名59岁男子因疼痛的右腹股沟肿块入院,6小时前突然发展。体格检查发现右腹股沟有一个4厘米×2厘米的肿块。质量很硬,由于压痛而无法减少。它没有下降到阴囊里。B超显示疝嵌顿。手术期间,疝气被发现包含阑尾,表现为远端无血管坏死。根据这种类型的腹股沟疝的分类标准诊断为DeGarengeot疝。腹腔镜下减少嵌顿疝,阑尾切除术,在急诊科进行了小切口股疝修补术,术后给予头孢呋辛抗感染治疗2d。治疗后,患者无腹痛或感染,术后第4天出院.随访16个月后,他没有腹股沟疝复发。
结论:DeGarengeot疝发病率低,诊断困难。腹腔镜检查对其诊断和治疗有用。