ABSTRACT
The involvement of kidney, perirenal fat, and ureter is a rare variant of inguinal hernia. We report a case of a 78-year-old man presenting with typical clinical signs of acute appendicitis. Ultrasonography and CT scan revealed ptosis of the right kidney with a major part of the perirenal capsule involved in a large right sided inguinal hernia with acute obstruction of the ureter and urostasis. Acute surgery was performed, involving resection of perirenal fat, liberation, resection, and neoimplantation of the ureter, and hernioplasty. The postoperative period was uneventful. This case illustrates diagnostic unpredictability of acute appendicitis as well as anatomic variety of inguinal hernias.
Subject(s)
Appendicitis , Hernia, Inguinal , Humans , Male , Aged , Hernia, Inguinal/surgery , Hernia, Inguinal/diagnosis , Hernia, Inguinal/diagnostic imaging , Hernia, Inguinal/complications , Diagnosis, Differential , Appendicitis/surgery , Appendicitis/diagnosis , Acute Disease , Ureteral Obstruction/etiology , Ureteral Obstruction/surgery , Ureteral Obstruction/diagnostic imagingABSTRACT
Primary hyperparathyroidism (PHPT) in pregnancy is rare and may be associated with increased maternal and fetal morbidity and mortality. The ideal timing for parathyroidectomy is during the second trimester, and parathyroidectomy in the third trimester is extremely rare. We present a case of a 32-year-old woman who was admitted to our hospital with severe hypercalcemia in the 36th week of her first pregnancy. Conventional bilateral neck exploration was performed and parathyroid adenoma was removed. The surgical procedure was tolerated well by the mother, and she delivered a healthy girl 10 days after surgery. The newborn had mild hypocalcemia that required minimal substitution postnatally; however, no tetany occurred. This case demonstrates that parathyroidectomy in the third trimester followed by spontaneous delivery may be performed safely.