Incarcerated gallbladder in inguinal hernia: a case report and literature review
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CASE REPORT
Incarcerated gallbladder in inguinal hernia: a case report and literature review János Tajti Jr., József Pieler, Szabolcs Ábrahám, Zsolt Simonka, Attila Paszt and György Lázár*
Abstract Background: Treating hernias is one of the oldest challenges in surgery. The gallbladder as content in the case of abdominal hernias has only been reported in a few cases in the current literature. Cholecyst has only been described in the content of an inguinofemoral hernia in one case to date. Case presentation: A 73-year-old female patient was admitted to the Emergency Department due to complaints in the right inguinal area, which had started 1 day earlier. The patient complained of cramp-like abdominal pain and nausea. Physical examination confirmed an apple-sized, irreducible hernia in the right inguinal region. Abdominal ultrasound confirmed an oedematous intestinal loop in a 70-mm-long hernial sac, with no circulation detected. Abdominal X-ray showed no signs of passage disorder. White blood cell count and C-reactive protein level were elevated, and hepatic enzymes were normal in the laboratory findings. Exploration was performed via an inguinal incision on the right side, an uncertain cystic structure was found in the hernial sac, and several small abnormal masses were palpated there. The abdominal cavity was explored from the middle midline laparotomy. During the exploration, the content of the hernial sac was found to be the fundus of the significantly ptotic, large gallbladder. Cholecystectomy and Bassini’s repair of the inguinal hernia were performed safely. Conclusions: Following a review of the literature, it can be concluded that the finding of incarcerated gallbladder in the content of an inguinal hernia is a rare finding. No other similar emergency case and successful surgical intervention have been reported before. Keywords: Incarcerated gallbladder, Hernia, Gallbladder strangulation, Case report Background Treating hernias is a routine and common surgical intervention and one of the oldest surgical challenges in the world. The majority, 80%, of hernias of the abdominal wall are inguinal hernias [1]. The most common hernial contents are the following: the greater omentum and certain intestinal segments (the small bowel, appendix, colon, urinary bladder, ovary and fallopian tube). In addition to surgical methods that have been modified several times over time, a number of rare hernial contents have been described; a
Meckel’s diverticulum [2] found by Alexandre Littré and an inflamed appendix described by Claudius Amyand [3] should be emphasised from the literature. However, a gallbladder as content in the case of inguinal hernias has only been reported in one case in the current literature [4]. After reviewing the literature, we have concluded that an incarcerated gallbladder in the content of an inguinal hernia is a rare finding, with no other similar cases reported before to the best of the authors’ knowledge. Our case report summarizes the diagnosis, surgical treatment and perioperat
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