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De la Peña-López Jairo; Silgado-Kerguelen Ricardo; Calderón-Morón Hernán (2011)
Publisher: Universidad de Cartagena
Journal: Revista Ciencias Biomédicas
Languages: Spanish
Types: Article
Subjects: Acute abdomen, Amyand´s hernia, Incarcerated hernia, Systemic inflammatory response syndrome (SIRS)., Medicine (General), R5-920, Medicine, R, DOAJ:Medicine (General), DOAJ:Health Sciences
Acute abdomen requiring surgical management is a frequent consultation at emergencydepartment. Acute appendicitis is the most common cause, however the presence ofacute appendicitis in an incarcerated inguinal hernia is rare, and this process is known asthe eponymous Amyand´s hernia. We report a case who presented with acute abdomenand a review of the literature. Our patient had a history of mild mental retardation;he had had clinical manifestations of abdominal pain one week earlier but family didnot give relevance to it. At consultation time, he presents a systemic inflammatoryresponse syndrome and acute abdomen with incarcerated right inguinal hernia; itwas performed resuscitation with optimization of vital signs and surgical managementwith the combined approach, finding a severe purulent peritonitis adhesive process.Drainage is performed and correction of the hernia with Bassini technique.RESUMEN:En el servicio de urgencia se observa con frecuencia la consulta de pacientes concuadros abdominales de presentación aguda, que ameritan intervención quirúrgica.La apendicitis aguda es la principal patología en orden de frecuencia, sin embargo lapresencia de una apendicitis aguda en un saco herniario inguinal incarcerado es pocofrecuente. Esta situación clínica es conocida con el nombre de hernia de Amyand.Se presenta caso clínico de un paciente con retardo mental leve, que presentó dolorabdominal con evolución de una semana. Al consultar se evidenció cuadro relacionadocon síndrome de respuesta inflamatoria sistémica y características clínicas de abdomenagudo con proceso herniario inguinal derecho incarcerado. En el acto quirúrgico seencontró peritonitis purulenta y un severo proceso adherencial. Se cumplió drenaje dela peritonitis y corrección de la hernia con técnica de Bassini.
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