Acute appendicitis in giant incarcerated umbilical hernia. A Case report

Umbilical hernias are a frequent reason for patients to visit surgeons. Typically, they are not considered emergencies due to the protrusion of the navel or its sides. However, when the hernia's contents become trapped or strangulated, it can lead to severe pain and intestinal obstruction, which requires immediate attention. In adults, this type of hernia is often associated with increased intra-abdominal pressure, primarily linked to obesity. The herniation occurs when there are defects in the umbilical abdominal wall fascia, allowing preperitoneal adipose tissue, omentum, or portions of the small or large intestine to protrude through the defect. In rare cases, the vermiform appendix is also included in the hernial sac, and even more infrequently, inflammation of the vermiform appendix can occur within the hernial sac. Although appendix-containing femoral hernias (known as de Garengeot hernias) and appendix-containing inguinal hernias (known as Amyand hernias) are more common, there have been only 12 documented case reports in the medical literature describing appendix-containing umbilical hernias. In this case report, we present another instance of appendicitis occurring within a complex umbilical hernia.