A CASE OF RIGHT INDIRECT INGUINAL HERNIA ASSOCIATED WITH INCARCERATION OF APPENDIX

Abstract

A 61-year-old man who had had right inguinal bulging for 2 years was brought to our hospital due to sudden enlargement and pain of the right inguinal region. The bulging was 5×10 cm in size and was diagnosed as incarcerated indirect inguinal hernia. Manual reduction of the incarceration was not successful. A CT scan revealed incarcerated solid mass with fat tissue in the inguinal canal and no sign of bowel obstruction. Since his abdominal finding was normal, we suspected that the content of hernia was greater omentum. Operation was performed on the next day according to his wish. Swollen appendix was disclosed when we opened the hernia sac. Normograde appendectomy was carried out and the surgical site was rinsed with enough amount of normal saline. The posterior wall of the inguinal canal was repaired by Bassini's procedure. Pathologically the appendicitis was diagnosed as phlegmonous and a focal abscess was found on the top of the appendix. Since the surgical site was infected postoperatively, open drainage was required. Four months after the operation, the infected wound was completely healed. We here report this case of inguinal hernia with an incarcerated appendix, which is a rare entity, together with some bibliographical comments.