First case of villous adenoma of the appendix leading to acute appendicitis presenting as strangulated femoral hernia: changes in management owing to concurrent adenoma.

Abstract

A 78-year-old lady presented with signs and symptoms of a strangulated femoral hernia. Peri-operatively she was found to have appendicitis within the hernia sac. Appendicectomy and non-mesh hernia repair were performed. Histology revealed acute inflammation and a villous adenoma of the appendix. Villous adenomas of the vermiform appendix are extremely rare tumours of the gastrointestinal tract. This is the first case combining two very rare pathologies--acute appendicitis presenting as strangulated femoral hernia and villous adenoma of the appendix. Early diagnosis and surgery are required to avoid high morbidity of perforated appendicitis within a femoral hernia. First, we discuss the diagnosis and surgical treatment of acute appendicitis within a femoral hernia. Second, the presence of an adenoma changes the aetiology of appendicitis. More importantly, changes in surgical management of acute appendicitis presenting as a strangulated femoral hernia owing to a co-existing adenoma are discussed.

• Authors: A Suppiah, J Barandiaran, R Morgan, E P Perry
• Journal: Hernia : the journal of hernias and abdominal wall surgery (Hernia) Vol. 12 Issue 1 Pg. 95-8 (Feb 2008) ISSN: 1265-4906 [Print] France
• PMID: 17566835 (Publication Type: Case Reports, Journal Article)

Topics

• Adenoma, Villous (complications, diagnosis)
• Aged
• Appendiceal Neoplasms (complications, diagnosis)
• Appendicitis (diagnosis, etiology, surgery)
• Female
• Hernia, Femoral (diagnosis, pathology, surgery)
• Humans