An incarcerated umbilical hernia containing an acute suppurative appendicitis in a significantly comorbid patient

Abstract

We present a rare case of a comorbid female in her 60’s with a long-standing umbilical hernia who presented to the emergency department with acute abdominal pain, three days of constipation and cellulitis of the overlying hernia skin. Imaging confirmed an incarcerated hernia containing the appendix and omental fat. The patient underwent emergency midline incision with appendicectomy and hernia defect repair under combines spinal epidural. Postoperative recovery was uneventful, and she was discharged without complications. This case underscores the rarity of appendiceal involvement in an incarcerated umbilical hernia, highlighting the importance of timely diagnosis and intervention to prevent severe complications such as ischemia, perforation, or peritonitis.