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      Irreducible inflamed inguinal hernia with infected gangrenous omentum after laparoscopic appendectomy: a case report

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          Abstract

          We reported a rare complication of laparoscopic appendectomy in a 19-year-old patient, who was admitted with acute appendicitis and had no history of inguinal hernia. He underwent laparoscopic appendectomy for suppurative appendicitis. Eight days later, he presented with irreducible incarcerated right inguinal hernia. A non-manifested congenital inguinal hernial sac has been symptomized after laparoscopic gas inflation inside the peritoneal cavity, which resulted in widening of the internal inguinal ring and protrusion of the omentum. Besides that, the omental content became inflamed and gangrenous as a consequence of the suppurative appendicitis and the presence of purulent fluid in the pelvis. Therefore, there were two complications that occurred simultaneously after laparoscopic appendectomy: a manifested right inguinal hernia and incarceration and gangrene of its contents. To our knowledge, this is the first reported case of irreducible inflamed inguinal hernia manifested for the first time after laparoscopic appendectomy.

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          Most cited references7

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          Laparoscopic appendectomy is superior to open appendectomy in obese patients.

          There are minimal data comparing laparoscopic appendectomy (LA) with open appendectomy (OA) in obese patients. We reviewed consecutive adult patients from 2003 to 2005 who underwent an appendectomy at a University-affiliated teaching hospital. Obesity was defined as a body mass index of 30 or greater. Outcome measures included length of stay, surgical times, intra-abdominal abscesses, wound infections, and hospital charges. There were 116 patients with a mean body mass index of 35. Eighty-five patients underwent LA, 12 were converted to open, 4 of 12 (31%) were perforated. Thirty-one patients underwent OA. Overall, 21 (18%) were perforated. Length of stay for LA was better, 3.4 days versus 5.5 days for OA (P = .02), and wound closure rate was better, 90% for LA versus 68% for OA (P < .01). Other outcome measures were equivalent. LA is associated with shorter lengths of stay, fewer open wounds, and equivalent hospital charges and intra-abdominal abscess rates; and should be considered the procedure of choice for obese patients with appendicitis.
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            Scrotal abscess following appendectomy.

            Postoperative infectious complications in children following perforated appendicitis present in diverse ways. We present two unusual complications of appendectomy for perforated appendicitis: an acute scrotum after open and laparoscopic appendectomy. A retrospective review of two cases of scrotal abscess following appendectomy at our hospital as well as a MEDLINE search was performed to review the clinical presentation, etiology, type of treatment, and outcome of these patients. Although scrotal inflammation occurring postoperatively in a patient with perforated appendicitis may be due to an incarcerated hernia, it is much more likely to be due to a scrotal abscess. Patients without a patent processus vaginalis or inguinal hernia at initial presentation of peritonitis must be carefully followed in the postoperative period and explored early if testicular or scrotal pain becomes manifest.
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              Infected hydrocele following laparoscopic appendectomy: case report.

              In the literature, specific reported complications after laparoscopic appendectomy include bowel injury, hemorrhage, wound infection, and cecal fistula. We report the occurrence of infected hydrocele after laparoscopic appendectomy in a 20-year-old man. This complication, to our knowledge, has not yet been described in the literature.
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                Author and article information

                Contributors
                Journal
                J Surg Case Rep
                J Surg Case Rep
                jscr
                Journal of Surgical Case Reports
                Oxford University Press
                2042-8812
                May 2021
                05 May 2021
                05 May 2021
                : 2021
                : 5
                : rjab172
                Affiliations
                Department of General Surgery , Nizwa Hospital , Nizwa, Al Dakhiliya, Oman
                Department of General Surgery , Nizwa Hospital , Nizwa, Al Dakhiliya, Oman
                Department of General Surgery , Nizwa Hospital , Nizwa, Al Dakhiliya, Oman
                Department of General Surgery , Nizwa Hospital , Nizwa, Al Dakhiliya, Oman
                Department of General Surgery , Nizwa Hospital , Nizwa, Al Dakhiliya, Oman
                Author notes
                Correspondence address. Department of General Surgery, Nizwa Hospital, Nizwa, Al Dakhiliya, Oman. Tel: +968 92431290; E-mail: dr_androadel@ 123456yahoo.com
                Article
                rjab172
                10.1093/jscr/rjab172
                8099461
                ea353f2c-eb2a-4fe4-8b19-f52545da25ac
                Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2021.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 25 March 2021
                : 11 April 2021
                Page count
                Pages: 3
                Categories
                Case Report
                AcademicSubjects/MED00910
                jscrep/040

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