Hypertrophied appendix epiploica strangulated in inguinal canal presenting as acute abdomen

A case report

Thien Vinh Luong, Alaa El-Hussuna

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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Resumé

Introduction: Different illnesses can affect the Epiploic Appendices (EA) of the Colon. Strangulation of the EA has previously been described inside a hernia sack associated with bowel herniation, but it is rarely presented as the only entity. This is the first case where a hypertrophied EA presented as acute abdomen mimicking a strangulated inguinal hernia. Presentation of the case: We present a case of a 71-year-old male who was admitted to the emergency department with acute pain around the left inguinal area. A firm mass measuring 5 × 6 cm had appeared sneezing, and had persisted for 24 hours with no nausea or vomiting. The patient had normal bowel motion on the same day. The hernia was not reducible. Because of suspicion of bowel strangulation inside the hernia sack, acute surgical intervention was performed. A hypertrophied EA was found in the hernia sack and treated with open herniotomy. The postoperative period was uneventful and the patient was discharged in good health four days following the operation. Discussion: Epiploic appendagitis caused by inflammation or strangulation can mimic other causes of acute abdomen but often presents a less severe clinical picture. The patient suffered from a strangulated hernia containing a hypertrophic EA. To our knowledge, this is the first case report of a hypertrophied EA inside an inguinal hernia requiring immediate operation. Conclusion: Hypertrophied EA can mimic a strangulated hernia. High index of suspicion is needed to diagnose this rare condition. Surgical intervention can both confirm the diagnosis and treat the condition.

OriginalsprogEngelsk
TidsskriftInternational Journal of Surgery Open
Vol/bind14
Sider (fra-til)27-29
Antal sider3
ISSN2405-8572
DOI
StatusUdgivet - 2018

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Inguinal Canal
Acute Abdomen
Appendix
Hernia
Colon
Inguinal Hernia
Sneezing
Groin
Acute Pain
Postoperative Period
Nausea
Vomiting
Hospital Emergency Service
Inflammation
Health

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abstract = "Introduction: Different illnesses can affect the Epiploic Appendices (EA) of the Colon. Strangulation of the EA has previously been described inside a hernia sack associated with bowel herniation, but it is rarely presented as the only entity. This is the first case where a hypertrophied EA presented as acute abdomen mimicking a strangulated inguinal hernia. Presentation of the case: We present a case of a 71-year-old male who was admitted to the emergency department with acute pain around the left inguinal area. A firm mass measuring 5 × 6 cm had appeared sneezing, and had persisted for 24 hours with no nausea or vomiting. The patient had normal bowel motion on the same day. The hernia was not reducible. Because of suspicion of bowel strangulation inside the hernia sack, acute surgical intervention was performed. A hypertrophied EA was found in the hernia sack and treated with open herniotomy. The postoperative period was uneventful and the patient was discharged in good health four days following the operation. Discussion: Epiploic appendagitis caused by inflammation or strangulation can mimic other causes of acute abdomen but often presents a less severe clinical picture. The patient suffered from a strangulated hernia containing a hypertrophic EA. To our knowledge, this is the first case report of a hypertrophied EA inside an inguinal hernia requiring immediate operation. Conclusion: Hypertrophied EA can mimic a strangulated hernia. High index of suspicion is needed to diagnose this rare condition. Surgical intervention can both confirm the diagnosis and treat the condition.",
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Hypertrophied appendix epiploica strangulated in inguinal canal presenting as acute abdomen : A case report. / Luong, Thien Vinh; El-Hussuna, Alaa.

I: International Journal of Surgery Open, Bind 14, 2018, s. 27-29.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Hypertrophied appendix epiploica strangulated in inguinal canal presenting as acute abdomen

T2 - A case report

AU - Luong, Thien Vinh

AU - El-Hussuna, Alaa

PY - 2018

Y1 - 2018

N2 - Introduction: Different illnesses can affect the Epiploic Appendices (EA) of the Colon. Strangulation of the EA has previously been described inside a hernia sack associated with bowel herniation, but it is rarely presented as the only entity. This is the first case where a hypertrophied EA presented as acute abdomen mimicking a strangulated inguinal hernia. Presentation of the case: We present a case of a 71-year-old male who was admitted to the emergency department with acute pain around the left inguinal area. A firm mass measuring 5 × 6 cm had appeared sneezing, and had persisted for 24 hours with no nausea or vomiting. The patient had normal bowel motion on the same day. The hernia was not reducible. Because of suspicion of bowel strangulation inside the hernia sack, acute surgical intervention was performed. A hypertrophied EA was found in the hernia sack and treated with open herniotomy. The postoperative period was uneventful and the patient was discharged in good health four days following the operation. Discussion: Epiploic appendagitis caused by inflammation or strangulation can mimic other causes of acute abdomen but often presents a less severe clinical picture. The patient suffered from a strangulated hernia containing a hypertrophic EA. To our knowledge, this is the first case report of a hypertrophied EA inside an inguinal hernia requiring immediate operation. Conclusion: Hypertrophied EA can mimic a strangulated hernia. High index of suspicion is needed to diagnose this rare condition. Surgical intervention can both confirm the diagnosis and treat the condition.

AB - Introduction: Different illnesses can affect the Epiploic Appendices (EA) of the Colon. Strangulation of the EA has previously been described inside a hernia sack associated with bowel herniation, but it is rarely presented as the only entity. This is the first case where a hypertrophied EA presented as acute abdomen mimicking a strangulated inguinal hernia. Presentation of the case: We present a case of a 71-year-old male who was admitted to the emergency department with acute pain around the left inguinal area. A firm mass measuring 5 × 6 cm had appeared sneezing, and had persisted for 24 hours with no nausea or vomiting. The patient had normal bowel motion on the same day. The hernia was not reducible. Because of suspicion of bowel strangulation inside the hernia sack, acute surgical intervention was performed. A hypertrophied EA was found in the hernia sack and treated with open herniotomy. The postoperative period was uneventful and the patient was discharged in good health four days following the operation. Discussion: Epiploic appendagitis caused by inflammation or strangulation can mimic other causes of acute abdomen but often presents a less severe clinical picture. The patient suffered from a strangulated hernia containing a hypertrophic EA. To our knowledge, this is the first case report of a hypertrophied EA inside an inguinal hernia requiring immediate operation. Conclusion: Hypertrophied EA can mimic a strangulated hernia. High index of suspicion is needed to diagnose this rare condition. Surgical intervention can both confirm the diagnosis and treat the condition.

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KW - Case report

KW - Epiploic appendices

KW - Inguinal hernia

KW - Irreducible inguinal hernia

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JO - International Journal of Surgery Open

JF - International Journal of Surgery Open

SN - 2405-8572

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