Acute Appendicitis Confined to an Incisional Hernia Following Renal Transplantation - Open Journal of Organ Transplant Surgery

OJOTS > Vol.3 No.3, August 2013

Acute Appendicitis Confined to an Incisional Hernia Following Renal Transplantation ()

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DOI: 10.4236/ojots.2013.33010 4,131 Downloads 6,273 Views Citations

Author(s)

Shanel Bhagwandin, Raquel Garcia-Roca, Hoonbae Jeon

Affiliation(s)

Department of Transplant Surgery, University of Illinois, Chicago, USA.

ABSTRACT

We present a case of a 57 years old moderately obese woman with a known 12 cmincisional hernia, who subsequently developed an incarcerated acute appendicitis. The patient underwent an uneventful orthotopic liver and renal transplant five years prior, and was compliant with ongoing immunosuppression without rejection. She presented with 8 hours of acute onset right lower quadrant pain, associated with anorexia, documented fevers, and nausea. Noncontrast CT demonstrated a blind-ending tubular structure with an enhancing and thickened wall within a hernia defect of the right lower quadrant. The patient underwent emergent laparotomy and a non-perforated appendix was completely excised at its base. Discussion: There have been documented reports of an acute appendicitis associated with inguinal hernias, given the eponym Amyand’s hernia. Appendicitis may present within hernias, and there should be a low threshold for radiologic assessment of its components when there is clinical doubt about the symptoms associated with the hernia. Our recommendation prompts early use of non-contrast CT scan in transplant patients with known hernias on examination and abdominal tenderness over the renal allograft considering the high risk of perforation of acute appendicitis and strangulation.

KEYWORDS

Acute Appendicitis; Renal Transplantation; Renal Allograft; Incisional Hernia; Amyand’s Hernia; Hernial Appendicitis

Share and Cite:

Bhagwandin, S. , Garcia-Roca, R. and Jeon, H. (2013) Acute Appendicitis Confined to an Incisional Hernia Following Renal Transplantation. Open Journal of Organ Transplant Surgery, 3, 50-52. doi: 10.4236/ojots.2013.33010.

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