Spontaneous evisceration of the appendix through an incisional hernia at rest

Vermiform Appendix within Post-Laparoscopic Incisional Hernia: A Unique Case Report and Literature Review

Background: Appendicitis within incisional hernia is an extraordinarily rare postoperative complication with an incidence range from 0.08 to 1%. From the 14 cases that we found in the English literature, only three present appendixes vermiform in incisional hernia followed by laparoscopic surgery. Only two cases are treated minimally invasively by the laparoscopic approach. Case presentation: We introduce a 65-year-old man who had a laparoscopic sigmoid colon resection and had a lump found at the 12 mm trocar site in the right iliac area in the late postoperative phase. There were no complaints from the patient. A vermiform appendix was unexpectedly discovered in the sac of that incisional hernia during control CT scans performed by chemotherapists. Laparoscopic hernia repair without appendectomy was performed. Postoperative outcomes were excellent. Conclusions: Because of low incidence and a lack of distinctive clinical presentation of appendicitis within incisional hernia, there is a risk of delayed perioperative diagnosis and treatment. A CT scan might play an important role in verifying the diagnosis early. For better postoperative outcomes, if possible, laparoscopic surgery should be chosen.

Spontaneous Evisceration of Incisional Hernia with Strangulation of Small Bowel: A Life Threatening Complication

Spontaneous evisceration of abdominal viscera is a rare complication of incisional hernia which could pose a serious threat to life if intervention is delayed. We report a case of a 62-year-old female with a history of curative resection for stage 1 endometrial adenocarcinoma 3 years ago, presenting with spontaneous evisceration of incisional hernia with strangulation of small bowel. Immediate resuscitation followed by emergency surgery was mandatory. During surgery, priority should be given to release the strangulation as soon as possible and the type of repair would depend on the viability of the bowel and the anatomy of the incisional hernia.