The present findings would lead us to recommend the use of EN rather than PN when possible and indicated.

Appendicitis and incarcerated hernia are frequently encountered reasons of emergency surgery for acute abdomen. The treatment in early stages of each condition is generally simple, but when these conditions are combined, the symptoms become slightly complicated, obscuring specific symptoms. Especially the lack of symptoms for appendicitis leads to delayed diagnosis, resulting in high morbidity. Amyand hernia, which contains appendix in its inguinal hernia sac, is perhaps more familiar to the general surgeons than De Garengeot hernia, which is an incarcerated femoral hernia with an appendix in its sac. We report the case of a 90-year-old female with incarcerated femoral hernia who underwent emergency hernioplasty only to reveal an inflamed appendix in its sac. The patient underwent both appendectomy and hernia repair simultaneously with synthetic mesh and was discharged on postoperative day 7 without any complications. We will also discuss the physical and radiological findings of De Garengeot hernia.

No abstract

It is not necessary to treat hypovascular liver tumors immediately after diagnosis.

Urinoma is defined as an encapsulated collection of chronically extravasated urine, usually located in the perirenal space. Crohn's disease (CD) complicating urinomas is very rarely reported, and we encountered a case of urinoma with CD which was located in the retroperitoneal space. Case presentationA 44-year-old female complained of abdominal distention as well as frequent urination. Contrast-enhanced CT scan showed a giant cystic mass, barium enema indicated entero-rectal fistula, and DIP revealed rectovesical fistula.By conservative therapy, inflammatory findings were improved. However, an abdominal tumor was still observed.Therefore, we performed an operation including ileocecal resection, resection of the fistulas, and repair of the urinary bladder and the rectum. The postoperative course was uneventful and 37 months later after the operation, the patient has no complaints. ConclusionOur case is the first report of Crohn's disease associated with urinoma. We believe that surgical therapy may be effective for patients who have urinoma with Crohn's disease.