Dud in the abdominal cavity
For three days the man has pain in the lower abdominal area. The 42-Year-old suffers but does not have Nausea, constipation or diarrhea. His body temperature is normal. With these complaints he seeks out the emergency room of the Hospital Son Llàtzer in Palma de Mallorca, Spain.
The doctors there make a note of his medical history. The man can take hormones, because he had to be removed at the age of 13 years, both testicles. Just ten days ago, he went to the doctor, had him move to a suspicion of gonorrhea antibiotics. Gonorrhea is a bacteria-caused sexually transmitted disease. Men suffer after an infection to start, and most of sub-vaginal discharge and pain when urinating. In the result, it can lead to inflammation, around the prostate, the seed heads or epididymis. By antibiotics are a gonorrhea usually heals quickly.
When the Doctors scan him, he has to feel in the middle and the right part of the abdomen pain. In the right groin area, the physician can feel a little harder. The Patient also has pressure pain. You suspect that it is a swollen lymph node.
A blood test indicates that the man has somewhere in the body inflammation: the value of The so-called C-reactive Protein, as well as the number of white blood cells are elevated.
Signs of a hernia operation
The Patient is therefore subjected to a ultrasonic. There signs of a hernia. This is a gap in the abdominal wall in the then parts of internal organs can slip. It is a so-called hernial SAC, in which, for example, a piece of the intestine is caught may be formed.
The radiologist will recognize the ultrasonic probe mainly an elongated structure, the hurts if pressure is applied. However, he can not make a sufficiently good picture of the Situation. Therefore, a computer tomography (CT). There, the experts see an inflamed Appendix, the tip of which is trapped in the hernia. This relatively rare phenomenon is referred to as Amyand hernia.
To confirm this diagnosis and remove the inflamed Appendix, the surgery, the Doctors and the patients. You can do this with a minimally invasive method of laparoscopy, in which only a small incision in the abdominal wall is necessary.
However, you will not find in the procedure what you expected. The man has no inguinal hernia. To the other of the cecum of 42 is not inflamed-Year-old at all and he’s not even in a fraction of the bag, but sitting safe and sound right where he belongs.
Elongated, inflamed structure
There is, however, the elongated, swollen structure, which was noticed in the ultrasound. Only this time it is not to the cecum of the patient. It’s the right seed head, which looks, as he was inflamed. Since the man has no testicles any more, the Doctors to remove the seed head and make a sample in the pathology study. After you finish the procedure.
As you speak to the OP with the patient, he says, to have the antibiotics are not taken. The pathology confirmed that the seed head was inflamed. So it is clear what happened: as a result of untreated gonorrhea it came down to the inflammation, which is not detected by the Doctors in the ultrasound and CT correctly.
The Doctors prescribe the man again antibiotics he’s taking now. Already on the day after the OP, he can leave the hospital. Quite self-critical, the Doctors write in the “International Journal of Surgery Case Reports” that the case illustrates how an inadequate doctor-patient conversation, in combination with a certain over-zealousness to treat a rare disease, and unnecessary surgical intervention.