Strangulated Appendix Epiploica in Paraumbilical Hernia: Preoperative Diagnosis and Laparoscopic Treatment

Abstract

Appendix epiploica can occasionally cause acute abdominal pain. The usual presentations are torsion or primary epiploic appendicitis. Strangulation inside a paraumbilical hernia with acute abdominal pain is seldom reported in the literature. The authors report a case of preoperative diagnosis and laparoscopic treatment of strangulated appendix epiploica in paraumbilical hernia that presented as acute abdominal pain.

Minimally invasive operating suite in the 21st century: Endo‐Lap operating room

“…However, the increased acceptance of laparoscopic surgery by the community and the speedy advancement of camera technology and laparoscopic devices have both led to an increased applicability 12 and wider penetration of these minimally invasive procedures. Increasingly, more and more complex surgical procedures can now be accomplished laparoscopically, 13–26 and the application has even extended into various surgical emergencies 27–34 . This necessitates increasing the number of complex equipment and mobile carts, cables, tubing and wiring to be installed into the MIS suite, which is practically stretched to its limit.…”

“…Increasingly, more and more complex surgical procedures can now be accomplished laparoscopically, [13][14][15][16][17][18][19][20][21][22][23][24][25][26] and the application has even extended into various surgical emergencies. [27][28][29][30][31][32][33][34] This necessitates increasing the number of complex equipment and mobile carts, cables, tubing and wiring to be installed into the MIS suite, which is practically stretched to its limit. The situation desperately calls for the development of a new type of OR to facilitate the safe performance of these technically and technologically demanding complex procedures.…”

A rare presentation of an acute appendicitis

“…They present as a lump and/or swelling commonly associated with abdominal discomfort and the majority are reducible; however, strangulation is not uncommon. The most common content of the sac is omentum, bowel loop and surgical repair remains the only definitive treatment [1, 2]. Appendicitis within the hernia sac has been reported in the inguinal (Amyand hernia) and femoral region (De Garengeot hernia); however, their presence in the paraumbilical hernia is extremely rare and a search of the literature demonstrated three previous perorated cases [3].…”