[The presense of acute appendicitis in the sac of inguinal hernia: case study]

Few cases have been reported in the literature on acute appendicitis located in the hernial sac. Information scantiness is determined by rarity of pathology and difficulties in diagnosis. Incidence rate of the condition is 0.4-0.6% of cases. The acute appendicitis is frequently located in the sac of right inguinal hernia or femoral hernia sac. The studies of three cases are presented in the article. In 1994-2007 at The Surgical Department of Phyphia Clinical Hospital (Tbilisi, Georgia) there have been performed 1064 hernia repairs. Entrapped hernia was diagnosed in 189 patients of whom three patients (from 70 to 84 years old, of whom two male and one female)--with acute perforated appendicitis located in hernia sac. In two cases perforated appendix was within the right inguinal hernia area and in one case--gangrenous appendix was located in femoral hernia sac. All three patients were operated upon routinely as for entrapped hernias. Laparoscopic inguinal herniotomy with removal of gangrenous-perforated appendix was performed in two patients. Herniotomy and laparotomy was performed in one patient. In spite of old age and heavy concomitant diseases postoperative period passed uneventfully. The patients were discharged from the Clinic under further ambulatory observation.