Appendicitis within the contents of an incarcerated paraumbilical hernia

Abstract

A 30-year-old woman known to have a paraumbilical hernia presented with central abdominal pain and vomiting. On examination, she was tender around the umbilical area, and a lump was felt on the umbilicus with associated skin changes. A CT scan was performed which showed an inflamed appendix within an incarcerated paraumblical hernia.

Umbilical Hernia Containing Appendicitis

“…Appendicitis presenting in an incarcerated umbilical hernia is an extremely rare phenomenon, with only 10 case reports of similar nature being available in the medical literature [6][7][8]. In this case, the suspected umbilical hernia contents were the omentum and small bowel, though there was no evidence of small bowel obstruction, which would be expected with a strangulated umbilical hernia containing small bowel.…”

A ventral hernia containing appendix; a case report and literature review

“…Surgical experience would suggest that the larger the hernia defect, the more likely the possibility of recurrence. Studies have borne this out, with a threshold of approximately 4 cm representing a 3-fold risk for recurrence [ 1 , 2 , 4 ].…”

“…For instance, the surgeon needs to perform an appendectomy instead of a simple hernia repair with anatomical fascial defect repair in the case of an abdominal wall hernia with acute appendicitis. Early diagnosis and management of abdominal wall hernia containing appendicitis are crucial, while it may cause infection, recurrence of hernia, edema, abscess, and abstractions of the intestine [ 1 , 2 ]. The widespread use of advanced imaging allowed the preoperative diagnosis of abdominal wall hernia with acute appendicitis.…”

“…Although the incidence is unknown, the National Center for Health Statistics estimates that approximately 5 million Americans have an abdominal wall hernia [ 1 , 3 ]. The factors known to contribute to hernia development include a physiologic change in fascial integrity, proteolysis associated with cigarette smoking, direct mechanical trauma, physical overexertion, abdominal aortic aneurysm, advanced age and familial genetic tendency [ 1 , 2 , 4 ].…”

Strangulated Caecum, Appendix, and Terminal Ileum in Paraumbilical Hernia: An Unusual Presentation in the Elderly

“…It remains unclear how the caecum can move freely to the midline and present inside the sac of a paraumbilical hernia. The possibility of an anatomical variation and aberrant cecum mobility, also known as mobile cecum syndrome, in 10% of the population has been reported [ 4 ].…”