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Case Reports
. 2021 May 1;16(7):1736-1739.
doi: 10.1016/j.radcr.2021.04.026. eCollection 2021 Jul.

Appendicitis in an incisional hernia sac following renal transplantation: A case report and brief review of the literature

Dhairya A Lakhani  1 , Jafar Dada  1 , Aneri B Balar  1 , Ahsan U Khan  1 , Zalak Patel  1 , Brian Markovich  2 , Thuan-Phuong Nguyen  3
Affiliations
Case Reports

Appendicitis in an incisional hernia sac following renal transplantation: A case report and brief review of the literature

Dhairya A Lakhani et al. Radiol Case Rep. .

Erratum in

Abstract

Acute appendicitis is a surgical emergency. However, the presence of vermiform appendix in a hernial sac is rare. It is even rarer to find inflamed appendix in an hernial sac. The most common site is right groin hernia (Inguinal > Femoral). There is low incidence of an incisional hernia following renal transplantation, as compared to patients with laparotomy. Appendicitis in hernial sac masquerades clinical presentation of an incarcerated hernia. Computed tomography plays a pivotal role in early diagnosis, demonstrating a dilated appendix with wall thickening and peri-appendiceal fat stranding. Patients are managed with appendectomy. The management of appendiceal hernias without inflammation remains controversial, with few reported cases managed with hernia sac repair or appendectomy. In this report were described a case of appendicitis in an incisional hernia following renal transplantation which was managed with appendectomy.

Keywords: Appendiceal hernia; Appendicitis; Incisional hernia.

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Figures

Fig 1
Fig. 1
CT abdomen and pelvis with intravenous contrast administration, coronal view (Figs. A-B) demonstrates a wide neck incisional hernia in the right lower quadrant containing a tubular structure (white arrow) with associated diffuse edema in the hernial sac. The tubular structure demonstrates mild mucosal enhancement and wall thickening. Of note: The image also includes, right polycystic kidney and transplanted kidney in the right Iliac Fossa.
Fig 2
Fig. 2
CT abdomen and pelvis with intravenous contrast administration, axial view demonstrates a wide necked incisional hernia in the right lower quadrant containing a tubular structure (white arrow) with associated diffuse edema in the hernial sac. Of note: The image also includes, transplanted kidney in the right Iliac Fossa.
Fig 3
Fig. 3
Prior CT abdomen and pelvis without intravenous contrast (performed 6 months prior to presentation) demonstrates presence of vermiform appendix (white arrow) in an incisional hernia sac. Of note: The image also includes, right polycystic kidney and transplanted kidney in right Iliac Fossa.
See this image and copyright information in PMC

References

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