A CASE OF INCARCERATED APPENDIX IN AN INGUINAL HERNIA PRESENTED WITH ABDOMINAL WALL ABSCESS
A CASE OF INCARCERATED APPENDIX IN AN INGUINAL HERNIA PRESENTED WITH ABDOMINAL WALL ABSCESS
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腹股沟疝阑尾嵌顿伴腹壁脓肿一例
DOI：
10.3919/jjsa.60.2494
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发表时间：
1999
期刊：
影响因子：
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通讯作者：
H. Shimoji
中科院分区：
文献类型：
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作者：
N. Koide;S. Mizuno;E. Asano;Yasuo Takahashi;H. Shimoji
嵌顿阑尾在腹股沟疝是一种罕见的情况。我们经历了一个罕见的病例腹股沟疝阑尾嵌顿引起的腹壁脓肿。一名71岁妇女因右腹股沟肿胀和脓性分泌物入院。她还患有雷克林豪森氏病。腹部CT示高密度区，腹壁内空气延伸至腹腔。我们在怀疑右嵌顿腹股沟疝并腹壁脓肿的情况下进行了紧急手术。对脓肿进行引流，但无法确定脓肿形成的原因。通过剖腹手术发现右腹股沟窝嵌顿阑尾。行阑尾切除、疝修补及腹膜引流术。术后再发脓肿引流。术后第五个月出院。此罕见病例术前诊断困难。在治疗无肠梗阻症状的嵌顿腹股沟疝时，我们必须考虑疝内容物可能是阑尾的可能性。
Incarcerated appendix in an inguinal hernia is an uncommon condition. We experienced a rare case of an abscess of the abdominal wall which was caused by an incarcerated appendix in an inguinal hernia. A 71-year-old woman was admitted to the hospital because of a right inguinal swelling and purulent discharge. She also had von Recklinghausen's disease. Abdominal CT revealed a high density area with the air in the abdominal wall extending to the peritoneal cavity. We performed an emergency operation on a suspicion of the right incarcerated inguinal hernia with abdominal wall abscess. A drainage for the abscess was per-formed but no cause of the abscess formation could be identified. An incarcerated appendix in the right inguinal fossa was found out by a laparotomy. Appendectomy, hernia repair and peritoneal drainage were carried out. After the operation, a recurrent abscess was drainaged. She was discharged on the fifth postoperative month. It was difficult to preoperatively diagnose this rare case. In the treatment of incarcerated inguinal hernia without ileus symptoms, we must entertain a possibility that the content of hernia may be the appendix.