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Incarcerated incisional hernia of the sigmoid colon after appendectomy: A case report

INTRODUCTION: Incisional hernia after appendectomy is rare, affecting 0.4% to 0.9% of cases. The small bowel and omentum are commonly herniated through the abdominal wall defect, but incisional hernia of the sigmoid colon is extremely rare. CASE PRESENTATION: A 78-year-old man presented with a right...

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Autor principal: Choi, Pyong Wha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241580/
https://www.ncbi.nlm.nih.gov/pubmed/28103499
http://dx.doi.org/10.1016/j.ijscr.2017.01.006
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author Choi, Pyong Wha
author_facet Choi, Pyong Wha
author_sort Choi, Pyong Wha
collection PubMed
description INTRODUCTION: Incisional hernia after appendectomy is rare, affecting 0.4% to 0.9% of cases. The small bowel and omentum are commonly herniated through the abdominal wall defect, but incisional hernia of the sigmoid colon is extremely rare. CASE PRESENTATION: A 78-year-old man presented with a right lower quadrant abdominal wall mass on the previous McBurney incision site. He had a history of appendectomy for appendicitis 40 years ago. Computed tomography (CT) showed the sigmoid colon herniated thorough the abdominal wall defect. During the operation, a feces-impacted sigmoid colon was found protruding through the defect of the abdominal wall. Reduction of the sigmoid colon into the peritoneal cavity and herniorrhaphy with primary repair were performed. DISCUSSION: The ascending and descending colon are fixed into the retroperitoneum, whereas the transverse and sigmoid colon are not, which can allow these bowel segments to herniate through a weak abdominal wall just as small bowel loops do. However, incisional hernia of the colon is extremely rare. The diagnosis of incisional hernia can be easily made because a reducible abdominal wall mass can be detected by physical examination. In cases with rare type of hernia, CT can identify unusual types of abdominal hernias and differentiate hernias from neoplasms, inflammatory disease, and hematoma. CONCLUSION: Although incisional hernia of the colon after appendectomy is extremely rare and preoperative diagnosis by physical examination is difficult, CT is a useful method to make the correct diagnosis, avoiding unnecessary invasive intervention, particularly in patients with an unusual abdominal wall mass.
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spelling pubmed-52415802017-01-26 Incarcerated incisional hernia of the sigmoid colon after appendectomy: A case report Choi, Pyong Wha Int J Surg Case Rep Case Report INTRODUCTION: Incisional hernia after appendectomy is rare, affecting 0.4% to 0.9% of cases. The small bowel and omentum are commonly herniated through the abdominal wall defect, but incisional hernia of the sigmoid colon is extremely rare. CASE PRESENTATION: A 78-year-old man presented with a right lower quadrant abdominal wall mass on the previous McBurney incision site. He had a history of appendectomy for appendicitis 40 years ago. Computed tomography (CT) showed the sigmoid colon herniated thorough the abdominal wall defect. During the operation, a feces-impacted sigmoid colon was found protruding through the defect of the abdominal wall. Reduction of the sigmoid colon into the peritoneal cavity and herniorrhaphy with primary repair were performed. DISCUSSION: The ascending and descending colon are fixed into the retroperitoneum, whereas the transverse and sigmoid colon are not, which can allow these bowel segments to herniate through a weak abdominal wall just as small bowel loops do. However, incisional hernia of the colon is extremely rare. The diagnosis of incisional hernia can be easily made because a reducible abdominal wall mass can be detected by physical examination. In cases with rare type of hernia, CT can identify unusual types of abdominal hernias and differentiate hernias from neoplasms, inflammatory disease, and hematoma. CONCLUSION: Although incisional hernia of the colon after appendectomy is extremely rare and preoperative diagnosis by physical examination is difficult, CT is a useful method to make the correct diagnosis, avoiding unnecessary invasive intervention, particularly in patients with an unusual abdominal wall mass. Elsevier 2017-01-05 /pmc/articles/PMC5241580/ /pubmed/28103499 http://dx.doi.org/10.1016/j.ijscr.2017.01.006 Text en © 2017 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Choi, Pyong Wha
Incarcerated incisional hernia of the sigmoid colon after appendectomy: A case report
title Incarcerated incisional hernia of the sigmoid colon after appendectomy: A case report
title_full Incarcerated incisional hernia of the sigmoid colon after appendectomy: A case report
title_fullStr Incarcerated incisional hernia of the sigmoid colon after appendectomy: A case report
title_full_unstemmed Incarcerated incisional hernia of the sigmoid colon after appendectomy: A case report
title_short Incarcerated incisional hernia of the sigmoid colon after appendectomy: A case report
title_sort incarcerated incisional hernia of the sigmoid colon after appendectomy: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241580/
https://www.ncbi.nlm.nih.gov/pubmed/28103499
http://dx.doi.org/10.1016/j.ijscr.2017.01.006
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