Faculty of Medicine

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    Amyand's hernia with gangrenous perforated appendicitis and diffuse peritonitis-case report
    (Oxford University Press (OUP), 2025-11)
    Gelevski, Radomir
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    Manevska, Vesna Jovanovska
    Amyand's hernia, the presence of the vermiform appendix within an inguinal hernia sac, is a rare clinical entity (0.2%-1.7% of inguinal hernias). Acute appendicitis within the sac is rarer still, occurring in only 0.1% of cases. We describe a male patient presenting with an incarcerated right inguinal hernia, who developed diffuse peritonitis after manual reduction. Laparotomy revealed gangrenous perforated appendicitis with purulent peritonitis. Appendectomy, partial omentectomy, and peritoneal lavage were performed. The patient recovered uneventfully. Amyand's hernia complicated by perforated appendicitis is an exceptional surgical emergency. Early recognition and prompt surgical management are crucial for favorable outcomes.
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    Pyonephrosis complicated with spontaneous intraperitoneal rupture and diffuse peritonitis: Case report and literature review
    (Dustri-Verlag, 2024-01)
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    Misimi, Shqipe
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    Draskacheva, Nadica
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    Limani, Nimetula
    Pyonephrosis is a serious condition that can lead to kidney dysfunction, loss of the organ, and even fatal end due to its complications. The underlying etiologic factors include lithiasis, recurrent urinary infections, ureter stricture, ureteropelvic junction obstruction, malignancy, and retroperitoneal fibrosis. One of the rare possible complications of pyonephrosis is a retroperitoneal rupture with spontaneous communication to the abdomen causing secondary peritonitis. We present such a case which is the first video-documented report of the peritoneal rupture site within the abdominal cavity.