Radiology Case Reports (Jul 2021)

Appendicitis in an incisional hernia sac following renal transplantation: A case report and brief review of the literature

  • Dhairya A. Lakhani, MD,
  • Jafar Dada, MD,
  • Aneri B. Balar, MD,
  • Ahsan U. Khan, MD,
  • Zalak Patel, MD,
  • Brian Markovich, MD,
  • Thuan-Phuong Nguyen, MD

Journal volume & issue
Vol. 16, no. 7
pp. 1736 – 1739

Abstract

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Acute appendicitis is a surgical emergency. However, the presence of vermiform appendix in a hernial sac is rare. It is even rarer to find inflamed appendix in an hernial sac. The most common site is right groin hernia (Inguinal > Femoral). There is low incidence of an incisional hernia following renal transplantation, as compared to patients with laparotomy. Appendicitis in hernial sac masquerades clinical presentation of an incarcerated hernia. Computed tomography plays a pivotal role in early diagnosis, demonstrating a dilated appendix with wall thickening and peri-appendiceal fat stranding. Patients are managed with appendectomy. The management of appendiceal hernias without inflammation remains controversial, with few reported cases managed with hernia sac repair or appendectomy. In this report were described a case of appendicitis in an incisional hernia following renal transplantation which was managed with appendectomy.

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