RESUMO
Epiploic appendagitis (EA) is a rare and frequently overlooked cause of abdominal pain. EA within the sigmoid colon in a right-sided inguinal hernia is a rare entity with only a few cases reported. In this article, we present a case of an 80-year-old male with a palpable mass within an incarcerated right inguinal hernia. The patient underwent urgent surgical intervention due to incarceration and the operative findings were of a large indirect inguinoscrotal hernia containing sigmoid colon, with an inflamed epiploic appendage. The colon was reduced into the abdominal cavity and standard tension-free Lichtenstein repair was performed. EA should be a consideration in patients with an acute abdomen as well as those with a painful groin lump. CT is diagnostic; however, emergency surgery should not be delayed for a scan if the hernia is irreducible and tender.
RESUMO
A 25-year-old longsighted woman presented with a history of spectacle and contact lens induced exacerbation of Tourette syndrome symptoms. Preoperatively, she had very poor unaided vision (6/60), achieving good (6/9) vision in both eyes with spectacle correction. The patient underwent bilateral simultaneous implantation of phakic implantable collamer lens (ICL) implants (STAAR, USA) which sit in front of the natural lens. Postoperatively, her uncorrected visual acuity was markedly improved as were her manifestations of Tourette syndrome. She achieved her full potential of unaided vision (6/9). This is the first documented case of Tourette syndrome triggered by glasses and contact lenses in which bilateral phakic toric lens implants were effective in improving vision and controlling motor symptoms. Phakic toric ICL implantation is a reversible technique for the correction of visually significant ametropia in selected patients and has improved this patient's quality of life.
