Strangulated appendix within a trocar site incisional hernia following laparoscopic low anterior rectal resection. A case report

Appendix strangulation caused by an incisional trocar site hernia following laparoscopy is an extremely rare entity. A 63-year-old man was admitted to our department with continuous abdominal pain and irreducible minimal swelling in the right abdomen. His surgical history was significant for rectal cancer one year previously. The patient had undergone a laparoscopic low anterior rectal resection with construction of a protective temporary end ileostomy (pT1, pN0, G2, M0). The ileostomy was reversed 3 months after initial surgery. An incarcerated herniation was diagnosed. Subsequent surgery surprisingly revealed that the right lower trocar point incisional hernia contained a strangulated appendix. Routine appendectomy was performed and the hernias were repaired using a typical sublay technique.