Laparoscopic Repair of a Femoral Hernia Involving the Appendix in a Patient With a History of Extracorporeal Membrane Oxygenation After Myocardial Infarction

TL;DR

A 61-year-old man with a history of heart attack and ECMO treatment underwent laparoscopic surgery for a femoral hernia involving the appendix.

Contribution

This case report highlights the successful use of laparoscopic surgery for a rare femoral hernia involving the appendix in a patient with a complex medical history.

Findings

Laparoscopic surgery successfully identified and treated the appendix within a femoral hernia.

The patient had no abscess and only mild inflammation in the appendix.

The association between VA-ECMO using the cutdown technique and femoral hernias remains unclear.

Abstract

We present the case of a patient who underwent laparoscopic appendectomy and transabdominal preperitoneal repair for a femoral hernia involving the appendix after myocardial infarction and required veno-arterial extracorporeal membrane oxygenation (VA-ECMO). We admitted a 61-year-old man who was experiencing swelling and pain in his right groin. His medical history included a myocardial infarction three years prior, for which he required VA-ECMO using the cutdown technique in our hospital. Abdominal computed tomography revealed a right femoral hernia involving the appendix, and the patient underwent laparoscopic surgery. During laparoscopy, the appendix, which had disengaged from the right femoral hernia, was facilitated by visualization. The appendix exhibited mild inflammation, and no abscess was found in the lumen of the right femoral hernia; therefore, the patient underwent laparoscopic appendectomy and transabdominal preperitoneal repair. In this patient with a femoral hernia involving the appendix, laparoscopic surgery was useful in the identification of the appendix, although the incarcerated appendix had disengaged from the femoral hernia at the time of surgery. Because it is unclear whether VA-ECMO using the cutdown technique is associated with femoral hernias, further case reports similar to ours would be valuable.

Figures