Appendicitis in Umbilical Hernia: A Case Report

Appendicitis and umbilical hernias are common and usually well recognizable surgical entities. However, when both are combined it may be more difficult to determine correct diagnosis and treat both entities concomitantly. We report the case of a patient who was diagnosed with an acute appendicitis within an umbilical hernia sac. The infection was limited to the hernia sac and treated by antibiotics and emergency incision and drainage of an accompanying abscess after which the patient recovered. The hernia, still containing the appendix, was corrected at a later stage, together with removal of the appendix. A 70-year-old man presented at the emergency department with a three-day history of abdominal pain and general discomfort. This was associated with an increased size of his earlier diagnosed umbilical hernia which was known for ten years and was previously small, reducible and asymptomatic. There were no symptoms of intestinal obstruction such as nausea, vomiting or distension of the abdomen,
nor were there defecation problems. Appendicitis in umbilical hernias is an extremely rare surgical entity. Imaging techniques will contribute to revealing correct diagnosis. The condition may be treated surgically or conservatively in the acute stage, followed by delayed correction of the hernia with or without interval appendectomy.