Amyand's hernia: case report and review of the literature

Abstract

The authors report a case of gangrenous acute appendicitis in the sac of an inguinal hernia (Amyand's hernia). After a review of the literature, they emphasise the extreme rarity of the case reported, they underline how the clinical picture is highly similar to that of a strangulated inguinal hernia. They affirm that appendicectomy and hernioplasty may be performed at the same time, since the repair of the hernia should be performed without prosthesis implantation due to the contamination of the operating field.

“Uncommon Contents of Inguinal Hernial Sac”: A Surgical Dilemma

“…Ultrasonography (USG), computed tomography scan, magnetic resonance imaging, or color Doppler is never carried out in the preoperative period, but if done, these investigations are very useful to confirm the presence of unusual organs as well as their vascularity in case of strangulated hernias. The presence of a normal vermiform appendix in an inguinal hernia sac is uncommon, with a reported incidence of 0.6 to 1 % of inguinal hernias [3,4]. It has generally been associated with large indirect inguinoscrotal hernias, but occasionally, direct hernias may also contain them [1,3].…”

“…The presence of a normal vermiform appendix in an inguinal hernia sac is uncommon, with a reported incidence of 0.6 to 1 % of inguinal hernias [3,4]. It has generally been associated with large indirect inguinoscrotal hernias, but occasionally, direct hernias may also contain them [1,3]. Acute appendicitis within an inguinal hernia accounts for 0.1 % of all cases [1].…”

Gangrenous Amyand’s hernia in neonate: A great clinical masquerader

“…Contrary to appen- dicitis which is rare in neonates, most cases of Amyand's hernia have been reported in premature neonates, infants and postmenopausal women. Majority of cases present as obstructed or strangulated inguinal hernia and even with perforation with generalized peritonitis, systemic signs and symptoms of appendicitis are rarely evident [3][4][5]. In our case the neonate presented with features of irreducible hernia and in spite of underlying gangrene of appendix, the features of bowel strangulation were completely masked.…”

Amyands Hernia: Report of Two Cases

“…All surgeons agree that if appendicitis exists, the repair of the hernia should be performed with Bassini or Shouldice techniques, without making use of synthetic meshes or plugs within the defect [2,6,7] due to the high risk of suppuration of such materials. In the case of a normal appendix, incidentally found within the hernia sac, the performance of a prophylactic appendectomy along with the hernia repair is not favored by many authors [8,9]. Appendectomy adds the risk of infection to an otherwise clean procedure.…”