AMYAND'S HERNIA; CASE SERIES AND OUR TEN YEARS EXPERIENCE. Amyand fıtığı; olgu serisi ve 10 yıllık deneyimimiz (original) (raw)

2012

Abstract

ABSTRACT We aim to share our clinic experience with Amyand's hernia, which is rare condition and has ongoing discussion about it's treatment. The files of patients with Amyand's hernia during the last ten years were reviewed retrospectively. The patients' demographic characteristics, diagnosis, treatment and early complications were assessed. Amyand's hernia was found on seven patients. All patients were male and mean age was 42. Four patients were operated with a diagnosis of strangulated right inguinal hernia, while others were undergoing elective surgery. One patient also had ileus. Inflamed appendix was viewed in two patients and normal appendix was viewed in five patients. All patients underwent appendectomy via hernia incision. Hernia have been treated with prolene mesh in four patients, using the method of darning in one patient and anatomical repair method in two patients. None of patients was observed early complications. Amyand's hernia especially has ongoing discussion in terms of treatment approach (appendectomy? or mesh application?). These cases are rare and diagnosed usually intraoperatively. The appropriate treatment approach in these cases such as performed appendectomy or not, should be decided according to the surgeon's intraoperative findings. In cases with appendicitis, hernia repair should be tought with anatomic repair, the method of darning or using biological materials resistant to infection along with using prosthetic materials. OZET Bu yazida, nadir gorulen ve tedavi yaklasimi acisindan tartismalarin devam ettigi Amyand fitigi ile ilgili tecrubelerimizi paylasmayi amacladik. Son on yilda Amyand fitigi tanisi alan hastalarin dosyalari retrospektif olarak incelenerek, demografik ozellikler, tani, tedavi ve erken donem komplikasyonlar acisindan degerlendirmeler yapildi. Toplam 7 hastada Amyand fitigi saptandi. Hepsi erkek olan hastalarin yas ortalamasi 42 olarak saptandi. Hastalardan 4'u inkarsere sag inguinal fitik tanisiyla, digerleri ise elektif sartlarda ameliyat edildi. Bir hastada ayni zamanda ileus tablosu mevcuttu. Iki hastada apendiks vermiformis inflame iken, 5 hastada normal olarak izlendi. Tum hastalara fitik kesisinden apendektomi uygulandi. Fitik 4 hastada prolen yama kullanilarak, 1 hastada ag orme yontemiyle ve 2 hastada anatomik tamir yontemiyle (yamasiz onarim) tedavi edilmisti. Hastalarin hicbirinde erken donem komplikasyon izlenmedi. Amyand fitigi ozellikle tedavi yaklasimi acisindan (apendektomi? yama uygulamasi?) tartismalarin devam ettigi nadir gorulen ve genellikle ameliyat sirasinda tani konulabilen olgulardir. Bu olgularda cerrah, uygun tedavi yaklasimina, ameliyat sirasindaki bulgulara gore karar vermelidir. Apandisit bulgularinin eslik ettigi olgularda; prostetik materyaller kullanmanin yani sira, anatomik tamir (yamasiz onarim), ag orme yontemi veya enfeksiyona direncli biyolojik materyallerle fitik tamiri yontemlerinin de kullanilabilecegi akilda bulundurulmalidir.

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