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CC BY 4.0 · Surg J (N Y) 2022; 08(04): e308-e311
DOI: 10.1055/s-0042-1758044
Case Report

Peri-appendicular Abscess in a Spigelian Hernia

Rany Aoun 
1   Department of Digestive Surgery, Hotel Dieu de France Hospital, University Saint Joseph Medical School, Beirut, Lebanon
,
Rhea Akel 
2   Department of Radiology, Hotel Dieu de France Hospital, University Saint Joseph Medical School, Beirut, Lebanon
,
Roger Noun
1   Department of Digestive Surgery, Hotel Dieu de France Hospital, University Saint Joseph Medical School, Beirut, Lebanon
,
Ghassan Chakhtoura
1   Department of Digestive Surgery, Hotel Dieu de France Hospital, University Saint Joseph Medical School, Beirut, Lebanon
› Author Affiliations Funding This study was financed with internal funds. No competing financial interests exist.
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Abstract

Background Spigelian hernias are a rare type of lateral ventral abdominal hernia and their content can include any of the intra-abdominal organs. Many cases have described the presence of a variety of abdominal organs in Spigelian hernias, but only few cases report the presence of an incarcerated appendicitis. Imaging is an important step in the diagnosis to avoid the lack of knowledge in such cases. Surgical treatment can be through open or laparoscopic approach, with or without using a mesh according to the size of the defect.

Case Report We report a case of an 82-year-old patient who presented with an acute appendicitis with peri-appendicular abscess strangulated in a right Spigelian hernia. The patient was successfully treated by a laparoscopic appendectomy, a surgical drainage of the abscess, and direct muscle approximation without using of mesh due to inflammation.

Conclusion Spigelian hernias with acute appendicitis in their content are a very rare condition. Clinical diagnosis is usually difficult and challenging and computed tomography scan is the imaging modality of choice. The treatment is surgical.

Keywords

acute appendicitis - Spigelian hernia

Patient Consent

The consent was clearly obtained from the patient.


Author Contributions

All the authors contributed equally.




Publication History

Received: 28 April 2021

Accepted: 01 August 2022

Article published online:
06 November 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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