Abstract：
An 85 year-old woman was transferred with a chief complaint of right thigh pain persisting for 5 days. Abdominal contrast-enhanced computed tomography clearly depicted a swollen appendix incarcerated in the right obturator cavity. She underwent an emergent laparoscopic appendectomy and the simultaneous repair of the obturator hernia. At laparoscopy, appendix was found to be incarcerated in the right obturator canal. The incarcerated appendix was successfully flushed out from the sac by spurting saline into the obturator hernia sac through the catheter inserted into the hernia sac. After a laparoscopic appendectomy, the hernia orifice was repaired using the uterine flap. The patient was discharged from the hospital without any sequelae. This report demonstrates a very rare case of obturator hernia incarcerated with appendix. Although patients with obturator hernia incarcerated with small intestine present with the symptoms related to bowel obstruction, patients with incarceration of appendix do not. Moreover, they would show no typical abdominal symptoms associated with acute appendicitis. Therefore, it is important to perform a radiological evaluation promptly to make a definitive diagnosis when a patient with persisting pain of the right thigh or right ileac fossa with a possibility of obturator hernia with incarceration of the appendix is encountered.
摘要：
一名85岁的妇女被转移，主要主诉右大腿疼痛持续5天。腹部对比增强计算机断层扫描清楚地描绘了右侧闭孔腔内的阑尾肿胀。她接受了紧急腹腔镜阑尾切除术和闭孔疝的同时修复。在腹腔镜检查中，发现阑尾被关在右闭塞管中。通过插入疝囊的导管将盐水喷入闭孔疝囊，将嵌顿的阑尾成功地从囊中冲洗出来。腹腔镜阑尾切除术后，疝口是用子宫瓣修复的。病人出院了，没有任何后遗症。本报告显示了一例非常罕见的阑尾嵌顿闭孔疝病例。尽管小肠嵌顿的闭孔疝患者存在与肠梗阻相关的症状，阑尾嵌顿的患者没有。此外，它们不会显示与急性阑尾炎相关的典型腹部症状。因此,当遇到患有右大腿或右回肠窝持续疼痛并可能伴有阑尾嵌顿的闭孔疝的患者时，必须及时进行放射学评估，以做出明确的诊断。
