Presentation
Colicky abdominal pain evolving over 24 hours, located in the right iliac fossa and radiating to the inguinal region. Associated fever and leukocytosis.
Patient Data
Inflammatory changes characterized by a slight amount of free fluid and increased pericecal fat density are identified in the right iliac fossa.
The cecal appendix is oriented out of the abdominal cavity through the right inguinal canal to a hernial sac in the inguinal region, with thickening of the wall and a transverse diameter of 1.1 cm.
There is a partially included moderate fluid collection in the right iliac fossa and paracolic gutter.
Case Discussion
The location of a vermiform appendix within the peritoneal sac in an indirect inguinal hernia is an extremely rare finding, occurring in approximately 1% of cases.
The association of this finding with inflammatory changes (appendicitis) is still much lower in incidence, occurring in 0.08% of the general population.
In this case, the radiological diagnosis was corroborated by intraoperative findings. During the postoperative period, the patient had inflammatory collections that required percutaneous drainage.
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