First case report of spigelian hernia containing the appendix after liver transplantation: Another cause for chronic abdominal pain.

Lucas Faraco Sobrado, Lucas Ernani, Daniel Reis Waisberg, Luiz Augusto Carneiro-D'Albuquerque, Wellington Andraus

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Article in International journal of surgery case reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0 citing papers in PubMed, 3 citations in OpenAlex.

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5 · Who and what money

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5 authors at 1 institution in 1 country.

Lucas Faraco SobradoDigestive Organs Transplant Unit, Department of Gastroenterology, Liver Transplantation Division, University of São Paulo School of Medicine, São Paulo, Brazil. Electronic address: lucas.sobrado@hc.fm.usp.br.

Lucas ErnaniDigestive Organs Transplant Unit, Department of Gastroenterology, Liver Transplantation Division, University of São Paulo School of Medicine, São Paulo, Brazil.

Daniel Reis WaisbergDigestive Organs Transplant Unit, Department of Gastroenterology, Liver Transplantation Division, University of São Paulo School of Medicine, São Paulo, Brazil.

Luiz Augusto Carneiro-D'AlbuquerqueDigestive Organs Transplant Unit, Department of Gastroenterology, Liver Transplantation Division, University of São Paulo School of Medicine, São Paulo, Brazil.

Wellington AndrausDigestive Organs Transplant Unit, Department of Gastroenterology, Liver Transplantation Division, University of São Paulo School of Medicine, São Paulo, Brazil.

Universidade de São Paulo · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAbdominal ventral hernias are common in chronic liver disease due to increased abdominal pressure and sarcopenia. Following liver transplantation, diagnosis of chronic abdominal pain is challenging because it may relate to immunosuppression, scaring or opportunistic infections. PRESENTATION OF CASE: A 62 years-old male presented with chronic abdominal pain one year following liver transplantation due to hepatocellular carcinoma. After work-up he was diagnosed with a Spigelian hernia containing the appendix. We did hernia repair with mesh but appendectomy was not performed since it showed no signs of inflammation. On follow-up the patient had complete resolution of the pain. DISCUSSION: This is the first case of spigelian hernia containing the appendix following liver transplantation. Mesh repair can be safely performed in this setting but incidental appendectomy is controversial due to higher morbidity and mortality. In this case report we discuss the relationship between liver transplantation, abdominal hernias and the pitfalls of incidental appendectomy.

conclusionUncommon ventral hernias are a possible cause for chronic abdominal pain after surgery and should be investigated with imaging studies. Mesh repair is safe but incidental appendectomy in the immunosuppressed is not encouraged due to increased morbidity.

Indexed as

Abdominal painAmyand herniaAppendixLiver transplantationSpigelian herniaSurgery

Identifiers

PMID32698282

DOI10.1016/j.ijscr.2020.06.003

PMCPMC7322101

OpenAlexW3036829087

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.