Introduction
Spigelian hernia is a rare differential diagnosis of abdominal pain. It affects mainly women above the fifth decade of life, more on the left side than on the right side, usually with comorbidities that lead to an increase in intra-abdominal pressure, described as risk factors for the outbreak of ventral hernias. The content of a ventral hernia might be an epiploic appendix and lead to appendagitis.
Presentation of case
This article presents the case of an 82-year-old female patient who presented epiploic appendagitis in a Spigelian hernia.
Discussion
Spigelian hernia is a rare type of ventral hernia, especially in association with an epiploic appendagitis. A literature search of this rare entity yielded three publications presenting epiploic appendagitis in a Spigelian hernia. The initial approach after the diagnosis should be adequate analgesia associated with surgical correction of the hernia. There is no gold standard treatment for the repair. European and American societies suggest that if there is no palpable nodule, laparoscopic repair is preferable, always using a mesh.
Conclusion
Epiploic appendagitis in a Spigelian hernia is a rare condition whose diagnosis is a big challenge. However, the correct diagnosis can lead to a shorter hospital stay, with less cost and avoid the use of unnecessary medications.
Dermoid cysts or mature cystic teratomas are mesenchymal neoplasms most commonly found in the ovaries, but which may occur in any location along the pathways of ectodermal cell migration. They are rarely seen in the pancreas, where they show a slight preference for the pancreatic head. We report a case of dermoid cyst of the pancreas in a 69-year-old male patient, discussing the epidemiology, clinical presentation, diagnosis and treatment of this neoplasm. Since preoperative diagnosis is difficult, given its rarity in this site, it is usually diagnosed by histopathology of the specimen.
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