The finding of acute appendicitis within a left inguinal hernia is extremely rare. We present the case of a 75-year-old male patient with a perforated appendix within a left inguinal hernia. The scarcity of this case makes diagnosis before surgery extremely difficult. The patient was admitted to the hospital with symptoms of incarcerated left inguinal hernia, without the presence of ileum. He underwent an appendectomy applying the Halsted technique for hernia repair. The postoperative course was uneventful and the patient was discharged from the hospital the 6th postoperative day.
Correspondence to Caroline Ewertsen, caroline.ewertsen@dadlnet.dk
DESCRIPTIONHydatid disease is an important infestation caused by the parasite Echinococcus granulosus. The liver is the most frequently involved organ (75%), followed by the lungs (15%) and the remainder of the body (10%). 1 We present a rarecaseofsubcutaneoushydatidcystinthetemporalregion, where a small cyst had been present for the previous 50 years. The patient was an elderly woman from Greece with a gradually enlarging mass in the left temporal fossa. During preoperative preparation, the skin covering the mass spontaneously ruptured, revealing a large cyst (figure 1) and more than 20 smaller cysts. The cysts were displacing the superficial muscles of the left temporal region and eroding the bone.The diagnosis was confirmed by H&E staining and treatment with albendazole was started on clinical suspicion immediately after surgery. Serological tests (direct haemagglutination) were negative and the patient had no anaphylactic reaction during her stay in hospital.Hydatid cysts located in the head and neck region are extremely rare, even in areas where echinococcal infestation is frequent.
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