[Strangulation of the appendix in an inguinal hernia sac in children]

A E Solov'ev1

  • 1Ryazan State Medical University, Ryazan, Russia.

Khirurgiia
|May 20, 2022
PubMed

Insights

Appendix infringement in pediatric inguinal hernias is rare and mimics other conditions, complicating diagnosis. Prompt surgical intervention via groin or combined abdominal/herniotomy approaches is crucial for successful treatment and preventing complications.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Clinical Diagnostics

Background:

  • Inguinal hernias are common in children, but appendix involvement is a rare complication.
  • Inflammation or strangulation of the appendix within a hernia sac presents diagnostic challenges.

Purpose of the Study:

  • To investigate the clinical presentation and treatment strategies for children with appendix infringement in inguinal hernias.
  • To highlight diagnostic difficulties and optimal surgical approaches.

Main Methods:

  • Observational study of 12 children with appendix in inguinal hernias.
  • Diagnostic tools included clinical examination, laboratory tests, ultrasound, Doppler, X-ray, and surgical pathology.
  • Detailed analysis of 4 clinical cases.

Main Results:

  • Four cases of appendix infringement were identified, two with strangulation.
  • Testicular infarction occurred in two children with strangulated inguinal hernia and appendiceal necrosis.
  • Combined abdominal and herniotomy access facilitated radical surgery for sliding hernias, preventing complications.

Conclusions:

  • Appendix infringement in pediatric inguinal hernias is infrequent and often presents with an atypical clinical picture mimicking other acute abdominal conditions.
  • Groin operative access is the primary surgical choice for incarcerated appendix in a hernia sac.
  • For sliding hernias with appendix involvement, combined abdominal and herniotomy approaches are recommended.
Abstract

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