DeGarengeot疝是包含阑尾的股疝。René-JacquesCroissantDeGarengeot于1731年首次描述了这种罕见的疝气。此后发表了许多病例报告,然而关于演示文稿的集体分析,诊断,管理,这种独特的疝气患者缺乏预后。
使用PubMed进行了系统评价,谷歌学者,Embase,和WebofScience的病例。关键词搜索包括\"DeGarengeot疝\"或\"股阑尾炎\"或\"股疝阑尾\"或\"足疝阑尾。\"为了便于审查,根据阑尾的大致外观和股疝的相关结构建立了分类系统.
在197份手稿中发现了122例。最常见的病例来自欧洲,但已在世界范围内报告。女性占主导地位(n=180,81.1%),平均年龄为69.8岁。最常见的症状是腹股沟隆起和腹股沟压痛(82.4%,n=183和79.7%,n=177)。在95.0%(n=211)的病例中,在身体检查中观察到腹股沟隆起,疝气上出现红斑的占33.3%(n=74)。只有31.5%(n=70)的病例通过影像学检查确定了DeGarengeot疝的术前诊断。最常见的手术方法是通过腹股沟切口。9.5%(n=21)的病例发生并发症,最常见的手术部位感染。阑尾最常见的情况是充血/发炎,在44.1%(n=98)的病例中发现,对应于设计的分类系统中的2A类。
总的来说,DeGarengeot疝被发现是罕见的和临床上的异质性,正如我们的分类系统所强调的那样。对这种独特的疝气进行分类的系统方法可以改善管理决策并有助于避免并发症。
A De Garengeot hernia is a femoral hernia that contains the appendix. This rare type of hernia was first described by René-Jacques Croissant De Garengeot in 1731. Numerous case reports have been published since then, yet collective analysis about the presentation, diagnosis, management, and outcomes of patients with this unique hernia is lacking.
A systematic review was performed using PubMed, Google Scholar, Embase, and Web of Science for cases of De Garengeot hernias. Keywords searched included \"De Garengeot hernia\" OR \"femoral appendicitis\" OR \"femoral hernia appendix\" OR \"crural hernia appendix.\" To facilitate review, a classification system was created based on the gross appearance of the appendix and related structures in the femoral hernia.
Two hundred and twenty-two cases were identified in 197 manuscripts. Cases most commonly came from Europe but have been reported worldwide. There was a female predominance (n = 180, 81.1%) and the mean age at presentation was 69.8 years. The most common presenting symptoms were a groin bulge and groin tenderness (82.4%, n = 183 and 79.7%, n = 177, respectively). A groin bulge was observed on physical exam in 95.0% (n = 211) of cases, and erythema over the hernia was present in 33.3% (n = 74). A pre-operative diagnosis of a De Garengeot hernia was established with imaging in only 31.5% (n = 70) of cases. The most common surgical approach was through a groin incision. Complications occurred in 9.5% (n = 21) of cases, most commonly surgical site infections. The most common condition of the appendix was congested/inflamed, found in 44.1% (n = 98) of cases and corresponding to class 2A in the classification system devised.
Overall, De Garengeot hernias were found to be rare and clinically heterogeneous, as highlighted by our classification system. A systematic approach to categorizing this unique hernia may improve management decisions and help avoid complications.