De Garengeot hernia

Garengeot 疝
  • 文章类型: Case Reports
    背景:DeGarengeot疝是一种罕见的包含阑尾的股疝子集。这在女性中更为常见。呈现的症状是非特异性的,因此诊断具有挑战性,并且对其治疗尚无共识。
    方法:一名曾接受过疝修补术的85岁男性患者,有4天的右腹股沟区疼痛和肿胀病史。在对比增强的计算机断层扫描扫描中,发现股疝中阑尾嵌顿。通过阑尾切除术和使用不可吸收的缝合线闭合缺损来管理。
    结论:由于它们的非特异性表现和临床症状减弱,因此对DeGarengeot疝的诊断仍然具有挑战性。通常导致术中识别。对于医生来说,认识到阑尾炎的这种罕见表现并熟悉可用的手术干预措施至关重要。然而,文献未就首选手术入路达成共识.
    结论:DeGarengeot疝仍然是一种罕见且具有挑战性的股疝表现,尤其是并发阑尾嵌顿导致急性阑尾炎时。手术管理应根据每个患者的独特情况进行调整。
    BACKGROUND: De Garengeot hernia is a rare subset of femoral hernias containing the vermiform appendix. It is more common in females. The presenting symptoms are non-specific hence diagnosis is challenging and there is no consensus on treatment of it.
    METHODS: An 85-year-old male patient who had previously undergone herniorrhaphy presented with a four-day history of pain and swelling in the right groin region. On a contrast-enhanced computed tomography scan it revealed incarceration of the appendix within femoral hernia. It was managed with appendectomy and closure of the defect using non-absorbable suture.
    CONCLUSIONS: Diagnosis of De Garengeot hernias remains challenging due to their non-specific presentation and attenuated clinical symptoms, often leading to intraoperative identification. It is crucial for physicians to recognize this rare presentation of appendicitis and be familiar with the available surgical interventions. However, the literature does not establish a consensus regarding the preferred surgical approach.
    CONCLUSIONS: De Garengeot hernia remains an uncommon and challenging presentation of femoral hernia, particularly when complicated by appendiceal incarceration leading to acute appendicitis. Surgical management should be tailored to each patient\'s unique circumstances.
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  • 文章类型: Case Reports
    囊内包含阑尾的股疝被称为DeGarengeot疝。这种情况相对罕见,但很重要,因为它结合了股疝和急性阑尾炎的并发症,这是两种不同的外科紧急情况。绞窄或嵌顿疝的临床发现可能会掩盖急性阑尾炎的体征。股疝囊内发炎的阑尾的存在使这两种情况的治疗变得复杂,并且需要仔细的手术计划。我们报告了一例87岁的女性,患有DeGarengeot疝,并发穿孔阑尾炎和绞窄小肠穿孔。
    A femoral hernia containing the appendix within the sac is known as De Garengeot hernia. This condition is relatively rare but is important to recognize because it combines the complications of both femoral hernia and acute appendicitis, which are two distinct surgical emergencies. Clinical findings of a strangulated or incarcerated hernia may obscure signs of acute appendicitis. The presence of the inflamed appendix within the femoral hernia sac complicates the management of both conditions and requires careful surgical planning. We report a case of an 87-year-old female with De Garengeot hernia, complicated by perforated appendicitis and strangulated small bowel with perforation.
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  • 文章类型: Case Reports
    我们报告了一例“DeGarengeot疝气”(DGH),当发炎的阑尾位于股疝内部时发生的一种罕见疾病。阑尾可能参与炎症或坏死过程,治疗是急诊手术。它通常是在手术过程中偶然发现的。它发生在所有股疝的0.5%-5%。在0.08%-0.13%的病例中,由于股管颈部狭窄,阑尾可能会出现炎症或坏死过程;在这些情况下,需要通过无标准外科手术进行紧急手术。在其他情况下,它通常是在疝的手术修补术中偶然发现的,或者很少在术前通过CT诊断。因此,我们研究的目的是报告一例DGH,描述CT的主要发现,以提高术前诊断。
    We report a case of \"De Garengeot\'s hernia\" (DGH), a rare condition that occurs when the inflamed appendix is localized inside a femoral hernia. The appendix may be involved in inflammatory or necrotic processes and the treatment is emergency surgery. It is usually discovered by chance during surgery. It occurs in 0.5%-5% of all femoral hernias. In 0.08%-0.13% of cases, the appendix can present inflammatory or necrotic processes due to the narrowness of the neck of the femoral canal; in these cases, an emergency surgery is required through a no standard surgical procedure. In the other cases, it is usually found accidentally during surgical repair of the hernia or more rarely diagnosed preoperatively by CT. Therefore, the purpose of our study is to report a case of DGH describing CT main findings in order to improve the preoperative diagnosis.
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  • 文章类型: Case Reports
    在报告的股疝中,阑尾在股疝中是一种罕见的腹壁疝,约为0.1%至0.5%[1]。我们报告了一例56岁的女性,其阑尾被困在右股骨管中。文献中很少有关于股疝中阑尾截留的报道。这种情况的管理包括抗生素,引流阑尾切除术,疝修补术和网片修复。
    Incarceration of the appendix within a femoral hernia is a rare condition of abdominal wall hernia about 0.1 to 0.5% in reported femoral hernia [1]. We report a case of a 56-year-old female whose appendix was trapped in the right femoral canal. There are few reports in the literature on entrapment of the appendix within a femoral hernia. The management of this condition includes antibiotics, drainage appendectomy, hernioplasty and mesh repair.
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  • 文章类型: Case Reports
    背景:DeGarengeot疝非常罕见,表示包含阑尾的股疝,可能会发炎,也可能不会发炎。鉴于其发病率低,对于德伦戈特疝的理想手术治疗尚无明确共识.
    方法:这是一例81岁的男性因阑尾发炎的绞窄性股疝入院并接受手术的病例报告。使用单个切口串联进行阑尾切除术和原发性疝修补术。
    结论:这里介绍的病例提供了一个独特的解释,说明了亚急性的Grengeot疝。在这种临床环境中,阑尾炎的真正发病机制受到质疑,通过相信阑尾炎可以在长期的Garengeot疝中偶尔出现的理论,考虑到患者表现的亚急性-慢性性质。此外,本文提供的病例代表少数病例,其中术前根据计算机断层扫描成像进行诊断,在绝大多数情况下,直到手术时才能做出明确的诊断。
    结论:由于缺乏前瞻性研究和随机对照试验,标准化的,基于证据的deGarengeot疝的最佳手术治疗方法仍然难以捉摸。早期识别和诊断以及考虑患者解剖结构和临床状态的个性化方法对于治疗DeGarengeot疝至关重要。
    BACKGROUND: De Garengeot hernia is exceedingly rare and denotes a femoral hernia containing the appendix, which may or may not be inflamed. Given its low incidence, there is no clear consensus on the ideal surgical management of a de Garengeot hernia.
    METHODS: This is a case report of an 81-year-old man who was admitted and operated on for a strangulated femoral hernia containing an inflamed appendix. Appendicectomy and primary hernia repair were performed in tandem using a single incision.
    CONCLUSIONS: The case presented here provides a unique account of a subacute presentation of a de Garengeot hernia. It draws into question the true pathogenesis of appendicitis in this clinical setting, by lending credence to the theory that appendicitis can arise sporadically within a long-standing de Garengeot hernia, given the subacute-on-chronic nature of the patient\'s presentation. Furthermore, the case presented herein represents the minority of cases in which the diagnosis is clinched preoperatively based on computer tomography imaging as, in the vast majority of cases, definitive diagnosis is not made until the time of operation.
    CONCLUSIONS: Due to the lack of prospective studies and randomised controlled trials, a standardised, evidence-based approach for the optimal surgical management of de Garengeot hernias remains elusive. Early recognition and diagnosis as well as an individualised approach that considers the patient\'s anatomy and clinical status are crucial to the management of De Garengeot hernias.
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  • 文章类型: Case Reports
    DeGarengeot疝是一种罕见的股疝。当股疝包含一个可能发炎,有时坏死的阑尾时,就会发生这种情况。这需要紧急手术.然而,疝气通常是在手术室偶然发现的,这给外科医生带来了额外的挑战。
    方法:一名64岁的男子,有1周的右腹股沟肿块疼痛病史。一个星期前,肿块是不可减少的,疼痛。超声成像显示1.5×2cm的局部浑浊液体集合,其中包含直径8mm的水肿肠环,怀疑是阑尾。因此,通过疝囊进行阑尾切除术。之后,使用McVay技术和2.0尼龙缝线修复疝气.手术后的一天,病人出院了,10天后他回到诊所,没有任何并发症。
    患者有慢性阻塞性肺疾病(COPD)病史,这是疝气的危险因素.他不得不忍受右股疝十年,直到它变得痛苦和不可逆转。超声波显示似乎是阑尾。为了避免复杂的阑尾炎和绞窄疝的可能后果,急诊手术是我们患者的适当选择。
    结论:股疝中阑尾的存在对外科医生的诊断和治疗提出了挑战,由于非典型的临床表现和放射学方法在诊断病情方面缺乏功效。
    UNASSIGNED: De Garengeot hernia is a rare case of a femoral hernia. It occurs when a femoral hernia contains a vermiform appendix that may be inflamed and sometimes necrotic, and this requires emergency surgery. However, the hernia is usually discovered by chance in the operating theater, which poses an additional challenge for surgeons.
    METHODS: A 64-year-old man presented with a 1-week history of a painful right groin lump. The lump is irreducible and painful on exert a week ago. Ultrasound imaging showed a 1.5 × 2 cm loculated turbid liquid collection containing an edematous intestinal loop measuring 8 mm in diameter that was suspected to be the vermiform appendix. Therefore, appendectomy was performed through the hernia sac. After that, the hernia was repaired using the McVay technique and 2.0 nylon sutures. One day after the operation, the patient was discharged, and he returned to the clinic after 10 days without any complications.
    UNASSIGNED: The patient has a history of chronic obstructive pulmonary disease (COPD), which is a risk factor for a hernia. He had to live with the right femoral hernia for ten years until it became painful and irreversible. Ultrasound revealed what appears to be an appendix. To avoid possible consequences of complicated appendicitis and strangulated hernia, emergency surgery was the appropriate choice for our patient case.
    CONCLUSIONS: The presence of an appendix in the femoral hernia poses a diagnostic and therapeutic challenge to surgeons, due to the atypical clinical picture and the lack of efficacy of radiographic methods in diagnosing the condition.
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  • 文章类型: Case Reports
    我们提出了一个有趣的病例,一个嵌顿的股疝,囊内有一个发炎的阑尾,也被称为DeGarengeot疝。这种类型的疝气很少见,法国外科医生René-JacqueCroissantdeGarengeot于1731年首次描述。一名64岁的妇女在右腹股沟区域出现疼痛肿块,被送往急诊科。在对腹部和骨盆进行计算机断层扫描(CT)扫描以评估肿块之后,确定了包含绞窄阑尾的股疝的诊断。随后,采用了混合手术方法,包括开放式疝修补术和腹腔镜阑尾切除术。
    We present an intriguing case of an incarcerated femoral hernia containing an inflamed appendix inside the sac, also known as a De Garengeot hernia. This type of hernia is a rare occurrence that was first described in 1731 by the French surgeon René-Jacque Croissant de Garengeot. A 64-year-old woman presented to the emergency department with a painful mass in the right groin region. Following a computed tomography (CT) scan of the abdomen and pelvis to evaluate the mass, the diagnosis of a femoral hernia containing a strangulated appendix was established. Subsequently, a hybrid surgical approach was utilized, consisting of an open hernia repair and a laparoscopic appendectomy.
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  • 文章类型: Case Reports
    UNASSIGNED:AdeGarengeot\'s疝是一种包含阑尾的股疝,约占所有股疝的0.8%。
    未经评估:本文描述了一例84岁女性腹痛,据信患有股疝嵌顿.患者接受了疝修补术,被发现患有累及阑尾的股疝,一个degarengeot的疝气。使用全腹膜外(TEP)方法修复股疝。
    UNASSIGNED:据报道有多种方法可以修复deGarengeot疝。在这种情况下,我们讨论了TEP方法成功修复了Garengeot疝。
    未经评估:虽然罕见,在评估患者的嵌顿性股疝时,必须保持鉴别。TEP方法为外科医生提供了进行各种疝修补的能力,无论在操作过程中遇到什么。
    UNASSIGNED: A de Garengeot\'s hernia is a femoral hernia containing the appendix and accounts for approximately 0.8% of all femoral hernias.
    UNASSIGNED: This paper describes a case of an 84-year-old female who presented with abdominal pain, believed to have an incarcerated femoral hernia. Patient underwent a hernia repair and was found to have a femoral hernia involving the appendix, a de Garengeot\'s hernia. The femoral hernia was repaired using a total extraperitoneal (TEP) approach.
    UNASSIGNED: There are a variety of reported ways to repair a de Garengeot hernia. In this case, we discuss the successful use of the TEP approach to repairing a de Garengeot hernia.
    UNASSIGNED: Although rare, a de Garengeot hernia must remain on the differential when evaluating a patient for an incarcerated femoral hernia. A TEP approach provides the surgeon the ability to perform a variety of hernia repairs, regardless of what is encountered during the operation.
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  • 文章类型: Case Reports
    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。
    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.
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  • 文章类型: Journal Article
    BACKGROUND: Emergency appendectomy is often performed for de Garengeot hernia. However, in some cases, there may be a chance to perform an appendix-preserving elective surgery.
    METHODS: A 76-year-old woman presented to our hospital with complaints of a right inguinal swelling, which we diagnosed as a de Garengeot hernia using computed tomography (CT). B-mode ultrasonography (US) of the mass showed an appendix 4-6 mm in diameter with a clear wall structure; color Doppler US showed pulsatile blood flow signal in the appendiceal wall. Twenty-eight days later, herniorrhaphy with transabdominal preperitoneal repair (TAPP) was performed without appendectomy. Another 70-year-old woman presented to our hospital with complaints of a painful bulge in the right inguinal region. The diagnosis of de Garengeot hernia was made using CT. B-mode US showed an appendix 5 mm in diameter with a clear wall structure. Color Doppler US showed a pulsatile blood signal in the appendiceal wall. Seven days later, herniorrhaphy with TAPP was performed without appendectomy.
    CONCLUSIONS: De Garengeot hernia is often associated with appendicitis; however, an appendix-preserving elective herniorrhaphy can be performed if US and intraoperative findings do not suggest appendicitis or circulatory compromise in the appendix.
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