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Femoral hernia appendix causing small intestinal obstruction.

J P Wyatt1, J S Varma

  • 1Department of Surgery, Western General Hospital, Edinburgh, UK.

Postgraduate Medical Journal
|March 1, 1992
PubMed
Summary
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A rare case of small intestinal obstruction was caused by an appendix acting as a band, twisting the intestine around itself and anchoring in a femoral hernia. This previously unreported mechanism highlights a unique complication of femoral hernias.

Area of Science:

  • Gastroenterology
  • Surgical Case Reports
  • Abdominal Surgery

Background:

  • Femoral hernias are common surgical conditions.
  • Appendiceal involvement in femoral hernias is a recognized, though infrequent, association.
  • Small intestinal obstruction is a serious complication requiring prompt diagnosis and management.

Observation:

  • An 88-year-old female presented with symptoms of a painful, irreducible right femoral hernia.
  • Intraoperative findings revealed distal small intestine obstructed by twisting around an uninflamed appendix.
  • The appendix tip was found to be fixed within the femoral hernia sac, acting as a constricting band.

Findings:

  • A novel mechanism of small intestinal obstruction secondary to appendiceal entrapment within a femoral hernia was identified.

Related Experiment Videos

  • The appendix, acting as a dynamic band, caused strangulation of the small bowel.
  • This specific presentation and mechanism have not been previously documented in medical literature.

    • Implications:

    • This case expands the differential diagnosis for small intestinal obstruction in patients with femoral hernias.
    • Highlights the importance of thorough intraoperative examination, even in seemingly routine hernia repairs.
    • Suggests that atypical presentations of appendiceal-femoral hernia associations can lead to unique surgical emergencies.