A Case of Femoral Hernia with Incarceration of the Phlegmonous Appendix

A 75-year-old man was admitted to hospital complaining of a right femoral swelling, Physical examination revealed a hard tumor in the femoral region, but pain and tenderness were not recognized, A plane abdominal xray showed no sign of ileus, Abdominal computed tomography revealed a tumor in the rig...

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Published inNippon Shokaki Geka Gakkai zasshi Vol. 39; no. 11; pp. 1741 - 1746
Main Authors Mizusaki, Kaoru, Saito, Eiichi
Format Journal Article
LanguageJapanese
Published The Japanese Society of Gastroenterological Surgery 2006
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ISSN0386-9768
1348-9372
DOI10.5833/jjgs.39.1741

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Abstract A 75-year-old man was admitted to hospital complaining of a right femoral swelling, Physical examination revealed a hard tumor in the femoral region, but pain and tenderness were not recognized, A plane abdominal xray showed no sign of ileus, Abdominal computed tomography revealed a tumor in the right femoral region, Laboratory data revealed the absence of leucocytosis, with a white blood cell count of 8, 880/mm3, and an elevated CRP level of 6, 5mg/dL, We suspected a femoral hernia with incarceration of the greater omentum, but the patiant did not consent to the operation, We thought that can observe a progress from the abdominal examination, the examination of the femoral region and the laboratory data, and we gave an antibiotic and performed the operation on the next day, A hernia sac with a cross section of 6×3cm was observed in the right femoral region during the operation, When we incised the hernia sac, we presume that the hernia content is the hypertrophic greater omentum, and resected the hernia content, But the hernia contet was the phlegmonous appendix, Upon study of the abdominal cavity from the same wound, we recognized redness and hypertrophy of the cecum, and remaind a part of appendix, An additional resection of the remained appendix was performed, and the McVay repair procedure was used to repair the femoral hernia, Here, we discuss the 17 cases including ours, report in Japanese medical literature.
AbstractList A 75-year-old man was admitted to hospital complaining of a right femoral swelling, Physical examination revealed a hard tumor in the femoral region, but pain and tenderness were not recognized, A plane abdominal xray showed no sign of ileus, Abdominal computed tomography revealed a tumor in the right femoral region, Laboratory data revealed the absence of leucocytosis, with a white blood cell count of 8, 880/mm3, and an elevated CRP level of 6, 5mg/dL, We suspected a femoral hernia with incarceration of the greater omentum, but the patiant did not consent to the operation, We thought that can observe a progress from the abdominal examination, the examination of the femoral region and the laboratory data, and we gave an antibiotic and performed the operation on the next day, A hernia sac with a cross section of 6×3cm was observed in the right femoral region during the operation, When we incised the hernia sac, we presume that the hernia content is the hypertrophic greater omentum, and resected the hernia content, But the hernia contet was the phlegmonous appendix, Upon study of the abdominal cavity from the same wound, we recognized redness and hypertrophy of the cecum, and remaind a part of appendix, An additional resection of the remained appendix was performed, and the McVay repair procedure was used to repair the femoral hernia, Here, we discuss the 17 cases including ours, report in Japanese medical literature.
Author Saito, Eiichi
Mizusaki, Kaoru
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References 13) 長澤圭一, 長谷川洋, 小木曽清二ほか: 大腿ヘルニア嵌頓の内容が蜂窩織炎性虫垂であった1例. 日臨外医会誌57: 194-196, 1996
21) 菅沼利行, 長谷和生, 識名敦ほか: 虫垂をヘルニア内容とする大腿ヘルニアと閉鎖孔ヘルニアが併存した1例. 日臨外会誌65: 1112-1116, 2004
10) Giffin JM: Incarcerated inflamed appendix in a femoral hernia sac, Am J Surg 115: 364-366, 1968
23) Fukukura Y, Chang SD: Acute appendicitis within a femoral hernia: multidetector CT findings, Abdom Imaging 30: 620-622, 2005
4) 吉井一博, 里輝幸, 赤木重典: 大腿ヘルニア症例の検討. 日臨外会誌61: 1693-1697, 2000
14) 三浦弘善, 稲山治, 須郷広之ほか: 大腿ヘルニア嵌頓の2例. 日臨外医会誌58: 2204, 1997
12) 朴泰範, 岡本亮爾, 塩田昌明ほか: 虫垂が嵌頓していた大腿ヘルニアの1例. 日外宝56: 333, 1987
16) 井上智博, 泉勝, 小川哲史ほか: 大腿ヘルニア内, 虫垂嵌頓の1例. 日消外会誌31: 466, 1998
19) 佐藤俊充, 玉内登志雄, 岡本哲也ほか: 粘液嚢胞腺腫並存虫垂が嵌頓した右大腿ヘルニアの一例. 日臨外会誌63: 648, 2002
18) 山本尚人, 橘尚吾, 中村昌樹ほか: 鼠径ヘルニア, 閉鎖孔ヘルニアを既往とし, 大腿ヘルニア虫垂嵌頓手術後に胆嚢軸捻転症を生じた1例. 臨外56: 821-824, 2001
15) 雨宮剛, 長谷川洋, 小木曽清二ほか: ヘルニア嵌頓の内容が虫垂であった二例. 日腹部救急医会誌17: 767, 1997
7) 大石明彦, 河田憲幸, 松野剛ほか: 大腿ヘルニア内虫垂嵌頓の1手術症例. 臨外51: 229-232, 1996
9) 伊木勝道, 野上厚志, 木山敞: 虫垂が嵌頓していた大腿ヘルニアの1例. 兵庫医師会医誌43: 26-28, 2000
6) Wakeley CPG, Lond DSC: Hernia of the vermiform appendix, a record of sixteen personal cases, Lancet 235: 1282-1284, 1938
2) 白子隆志, 玉舎美智夫, 横尾直樹ほか: 当院で経験した大腿ヘルニア手術79症例の臨床的検討. 高山赤十字病紀25: 3-7, 2001
8) 寺岡均, 竹内一浩, 櫻井克宣ほか: 大腿ヘルニア内虫垂嵌頓の1例. 日消外会誌38: 98-101, 2005
3) 大谷五良: 鼠径ヘルニア, 大腿ヘルニア. 外科47: 1243-1249, 1985
1) 吉谷新一郎, 岸本圭永子, 原田英也ほか: 大腿ヘルニア症例の臨床的検討. 外科63: 354-358, 2001
11) 秋山太津男, 島敦之, 稲葉周作ほか: 虫垂の嵌頓を来した稀な大腿ヘルニアの1手術例. 神奈川医会誌13: 77, 1986
20) 齋藤心, 小島正幸, 清水敦ほか: 膿瘍を形成した大腿ヘルニア内虫垂嵌頓の1例. 臨外59: 371-374, 2004
24) Watkins RM: Appendix abscess in a femoral hernial sac-case report and review of the literature, Postgrad Med J 57: 306-307, 1981
5) Akopian G, Alexander M: de Garengeot hernia: appendicitis within a femoral hernia, Am Surg 71: 526-527, 2005
17) Takemura M, Iwamoto K, Goshi S et al: Strangulated femoral hernia containing gangrenous appendicitis: report of a case, 日外科系連会誌25: 789-791, 2000
22) 大迫智, 臼井智彦, 西田智樹ほか: CTにて術前診断しえた大腿ヘルニア内壊疽性虫垂炎の1例. 日消外会誌38: 701-705, 2005
References_xml – reference: 11) 秋山太津男, 島敦之, 稲葉周作ほか: 虫垂の嵌頓を来した稀な大腿ヘルニアの1手術例. 神奈川医会誌13: 77, 1986
– reference: 19) 佐藤俊充, 玉内登志雄, 岡本哲也ほか: 粘液嚢胞腺腫並存虫垂が嵌頓した右大腿ヘルニアの一例. 日臨外会誌63: 648, 2002
– reference: 23) Fukukura Y, Chang SD: Acute appendicitis within a femoral hernia: multidetector CT findings, Abdom Imaging 30: 620-622, 2005
– reference: 24) Watkins RM: Appendix abscess in a femoral hernial sac-case report and review of the literature, Postgrad Med J 57: 306-307, 1981
– reference: 3) 大谷五良: 鼠径ヘルニア, 大腿ヘルニア. 外科47: 1243-1249, 1985
– reference: 7) 大石明彦, 河田憲幸, 松野剛ほか: 大腿ヘルニア内虫垂嵌頓の1手術症例. 臨外51: 229-232, 1996
– reference: 13) 長澤圭一, 長谷川洋, 小木曽清二ほか: 大腿ヘルニア嵌頓の内容が蜂窩織炎性虫垂であった1例. 日臨外医会誌57: 194-196, 1996
– reference: 18) 山本尚人, 橘尚吾, 中村昌樹ほか: 鼠径ヘルニア, 閉鎖孔ヘルニアを既往とし, 大腿ヘルニア虫垂嵌頓手術後に胆嚢軸捻転症を生じた1例. 臨外56: 821-824, 2001
– reference: 14) 三浦弘善, 稲山治, 須郷広之ほか: 大腿ヘルニア嵌頓の2例. 日臨外医会誌58: 2204, 1997
– reference: 1) 吉谷新一郎, 岸本圭永子, 原田英也ほか: 大腿ヘルニア症例の臨床的検討. 外科63: 354-358, 2001
– reference: 16) 井上智博, 泉勝, 小川哲史ほか: 大腿ヘルニア内, 虫垂嵌頓の1例. 日消外会誌31: 466, 1998
– reference: 21) 菅沼利行, 長谷和生, 識名敦ほか: 虫垂をヘルニア内容とする大腿ヘルニアと閉鎖孔ヘルニアが併存した1例. 日臨外会誌65: 1112-1116, 2004
– reference: 8) 寺岡均, 竹内一浩, 櫻井克宣ほか: 大腿ヘルニア内虫垂嵌頓の1例. 日消外会誌38: 98-101, 2005
– reference: 22) 大迫智, 臼井智彦, 西田智樹ほか: CTにて術前診断しえた大腿ヘルニア内壊疽性虫垂炎の1例. 日消外会誌38: 701-705, 2005
– reference: 9) 伊木勝道, 野上厚志, 木山敞: 虫垂が嵌頓していた大腿ヘルニアの1例. 兵庫医師会医誌43: 26-28, 2000
– reference: 20) 齋藤心, 小島正幸, 清水敦ほか: 膿瘍を形成した大腿ヘルニア内虫垂嵌頓の1例. 臨外59: 371-374, 2004
– reference: 6) Wakeley CPG, Lond DSC: Hernia of the vermiform appendix, a record of sixteen personal cases, Lancet 235: 1282-1284, 1938
– reference: 12) 朴泰範, 岡本亮爾, 塩田昌明ほか: 虫垂が嵌頓していた大腿ヘルニアの1例. 日外宝56: 333, 1987
– reference: 17) Takemura M, Iwamoto K, Goshi S et al: Strangulated femoral hernia containing gangrenous appendicitis: report of a case, 日外科系連会誌25: 789-791, 2000
– reference: 5) Akopian G, Alexander M: de Garengeot hernia: appendicitis within a femoral hernia, Am Surg 71: 526-527, 2005
– reference: 10) Giffin JM: Incarcerated inflamed appendix in a femoral hernia sac, Am J Surg 115: 364-366, 1968
– reference: 2) 白子隆志, 玉舎美智夫, 横尾直樹ほか: 当院で経験した大腿ヘルニア手術79症例の臨床的検討. 高山赤十字病紀25: 3-7, 2001
– reference: 15) 雨宮剛, 長谷川洋, 小木曽清二ほか: ヘルニア嵌頓の内容が虫垂であった二例. 日腹部救急医会誌17: 767, 1997
– reference: 4) 吉井一博, 里輝幸, 赤木重典: 大腿ヘルニア症例の検討. 日臨外会誌61: 1693-1697, 2000
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Snippet A 75-year-old man was admitted to hospital complaining of a right femoral swelling, Physical examination revealed a hard tumor in the femoral region, but pain...
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StartPage 1741
SubjectTerms femoral hernia
incarceration of appendix
Title A Case of Femoral Hernia with Incarceration of the Phlegmonous Appendix
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