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Appendicitis-I: Introduction

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Posterior Approach for Debridement of the Psoas Abscess

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Published on: March 2, 2020

Peri-appendicular Abscess in a Spigelian Hernia.

Rany Aoun¹, Rhea Akel², Roger Noun¹

¹Department of Digestive Surgery, Hotel Dieu de France Hospital, University Saint Joseph Medical School, Beirut, Lebanon.

Surgery Journal (New York, N.Y.)

|November 9, 2022

Summary

This summary is machine-generated.

Spigelian hernias are rare abdominal wall defects. This case highlights acute appendicitis within a Spigelian hernia, a very uncommon presentation requiring prompt diagnosis and surgical intervention.

Keywords:

Spigelian hernia acute appendicitis

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Area of Science:

Abdominal surgery
Gastroenterology
Medical imaging

Background:

Spigelian hernias are rare lateral ventral abdominal wall defects.
They can contain various intra-abdominal organs, but incarcerated appendicitis is exceptionally rare.
Diagnosis often relies on advanced imaging techniques.

Observation:

An 82-year-old patient presented with symptoms of acute appendicitis.
The condition was found to be strangulated within a right Spigelian hernia, complicated by a peri-appendicular abscess.
Computed tomography (CT) scan confirmed the diagnosis.

Findings:

Successful laparoscopic appendectomy and abscess drainage were performed.
Direct muscle approximation was utilized for hernia repair due to significant inflammation, foregoing mesh.
The patient recovered well following the surgical intervention.

Implications:

This case underscores the importance of considering unusual presentations of appendicitis in Spigelian hernias.
Computed tomography is crucial for accurate diagnosis in challenging clinical scenarios.
Laparoscopic approaches offer a viable treatment option for complicated Spigelian hernias.