Our Surgeon Dr Olga Koop already suspected the diagnosis
The 65-year-old patient hailing from Cusco State was heavily overweight and also had a football-sized incisional hernia in front of her abdominal wall. After a gynaecological operation in her past the scar had given way and in the course of time created a massive hernia sac. And it was there where it hurt. After a thorough bodily investigation Dr Martina John ordered that a CT-scan be made.
After one look at the CT-picture our general surgeon had a certain suspicion which was confirmed during the procedure. In the sac she found the cecum, attached to which was the ulcerated appendix; it was already broken through. Dr Koop performed the appendectomy and sewed up the skin layers.
But why did the surgeon not also operate the incisional hernia? Two reasons are to be given: first, the entire contents of the hernia would hardly have had enough room in the pelvic region, and second, in dealing with such large hernias one has to sew a synthetic net into the abdominal wall. Accompanied by an appendicitis – furthermore, a perforated one – it would have definitely been contraindicative due to the high risk of infection.