A Case of Femoral Hernia with Incarceration of the Phlegmonous Appendix

Kaoru Mizusaki and Eiichi Saito

Department of Surgery, Seki Hospital

A 75-year-old man was admitted to hospital complaining of a right femoral swelling. Physical examination revealed a hard tumor in the femoral region, but pain and tenderness were not recognized. A plane abdominal x-ray showed no sign of ileus. Abdominal computed tomography revealed a tumor in the right femoral region. Laboratory data revealed the absence of leucocytosis, with a white blood cell count of 8,880/mm³, and an elevated CRP level of 6.5 mg/dL. We suspected a femoral hernia with incarceration of the greater omentum, but the patiant did not consent to the operation. We thought that can observe a progress from the abdominal examination, the examination of the femoral region and the laboratory data, and we gave an antibiotic and performed the operation on the next day. A hernia sac with a cross section of 6×3 cm was observed in the right femoral region during the operation. When we incised the hernia sac, we presume that the hernia content is the hypertrophic greater omentum, and resected the hernia content. But the hernia contet was the phlegmonous appendix. Upon study of the abdominal cavity from the same wound, we recognized redness and hypertrophy of the cecum, and remaind a part of appendix. An additional resection of the remained appendix was performed, and the McVay repair procedure was used to repair the femoral hernia. Here, we discuss the 17 cases including ours, report in Japanese medical literature.

Key words
femoral hernia, incarceration of appendix

Reprint requests
Kaoru Mizusaki Department of Surgery, Seki Hospital
1-3 Midori-cho, Mishima, 411-0848 JAPAN

Accepted
April 26, 2006

To read the PDF file you will need Abobe Reader installed on your computer.