PDF(Pubmed)
Abstract：
BACKGROUND: An incarcerated hernia is a common cause of acute abdominal pain. There are various types of incarcerated hernias, including incarcerated hernias of the appendix. These hernias are often complicated by appendiceal inflammation, necrosis, and suppuration, which affect the outcome of surgical repair. A De Garengeot hernia is a femoral hernia that contains the appendix. This type of hernia has a low incidence. When a De Garengeot hernia is clinically suspected, emergency surgical treatment should be performed as soon as possible.
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.
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.
摘要：
背景：嵌顿疝是急性腹痛的常见原因。有各种类型的嵌顿疝,包括阑尾嵌顿疝.这些疝通常会并发阑尾炎症，坏死,和化脓，影响手术修复的结果。DeGarengeot疝是包含阑尾的股疝。这种类型的疝气发病率低。当临床上怀疑有DeGarengeot疝时，应尽快进行紧急手术治疗。
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。
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。
