Inflamed vermiform appendix within the sac of incarcerated left inguinal hernia

A 54-year-old male complained of a continuous pain together with an irreducible swelling of the left inguinal region 8 hours prior to admission to the surgical emergency department. His physical examination revealed a very painful, erythematous, irreducible swelling in the left inguinal region without abdominal peritoneal irritation. Routine blood tests disclosed mild leukocytosis. Abdominal plain X-ray film was not specific, and ultrasonography revealed a 10 cm in length inactive, edematous intestinal section within the inguinal hernia. With the diagnosis of strangulated inguinal hernia, he underwent surgical exploration through a transverse inguinal incision. By opening the hernia sac, 6-8 cc inflammatory fluid drained out, and an inflamed vermiform appendix adhered to the inner surface of the sac was seen. Appendicectomy and primary hernia repair were performed at the same time through the inguinal incision. The postoperative course was uneventful, and the histological examination of the specimen revealed an inflamed appendix.

Boðulmuþ sol kasýk fýtýðý içinde inflame vermiform apendiks

Elli dört yaþýnda erkek hasta, 8 saat önce baþlayan sol kasýkta sürekli aðrý ve redükte olmayan þiþlik þikayeti ile acil cerrahi servisine baþvurdu. Fiziksel incelemede karýnda hassasiyet yoktu, sol kasýkta oldukça aðrýlý, eritemli ve redükte olmayan þiþlik vardý. Rutin kan testlerinde hafif lökositoz saptandý. Düz karýn grafisinde özellik yoktu, ultrasonografide sol inguinal kanalda 10 cm uzunluðunda, hareketsiz, ödemli ince baðýrsak ansý görüldü. Boðulmuþ sol kasýk fýtýðý tanýsýyla hasta ameliyata alýndý. Kasýða transvers kesi yapýlarak fýtýk kesesi ortaya konuldu. Kese açýldýðýnda 6-8 cc pürülan sývý geldi, vermiform apendiks inflame ve kese iç duvarýna yapýþýk durumdaydý. Ayný seansta hem apendektomi hemde primer fýtýk onarýmý yapýldý. Ameliyat sonrasý komplikasyon geliþmedi. Patolojik inceleme inflame apendiks ile uyumluydu.