Drain-site hernia containing the vermiform appendix: report of a case

Area of Science:

• Abdominal Surgery
• Gastroenterology
• Surgical Complications

Background:

• Herniation of the vermiform appendix (appendix) is uncommon through surgical drain sites.
• Drain-site hernias can contain unexpected intra-abdominal structures.
• Prior intraperitoneal drainage increases the risk of developing drain-site hernias.

Purpose of the Study:

• To report a rare case of appendiceal herniation through a drain site.
• To emphasize the potential for unexpected contents within drain-site hernias.
• To raise awareness of drain-site hernia risks in patients with prior drainage procedures.

Main Methods:

• Computed tomography (CT) scan for diagnosis.
• Diagnostic laparoscopy.
• Appendectomy.
• Direct closure of abdominal wall defect with mesh reinforcement.

Main Results:

• A 62-year-old woman presented with right lower quadrant pain seven years post-Roux-en-Y Cystojejunostomy.
• CT scan revealed herniation of the vermiform appendix through a former drain site.
• Successful surgical repair via laparoscopy with appendectomy and mesh reinforcement was performed.

Conclusions:

• Drain-site hernias are an infrequent but significant complication.
• Patients with a history of intraperitoneal drains are at risk for these hernias.
• Prompt diagnosis and surgical intervention are crucial for managing drain-site hernias.