Amyand’s hernia in premature neonates: report of two cases

Abstract

The finding of a normal or inflamed vermiform appendix within an inguinal hernia is termed Amyand's hernia. It is extremely rare in children, especially in infants and neonates. When it occurs, it is usually misdiagnosed as an irreducible or strangulated inguinal hernia, and the accurate diagnosis is made intraoperatively. We report two cases of Amyand's hernia in premature neonates. Both patients presented on admission with signs and symptoms indicating a strangulated right inguinal hernia, and the accurate diagnosis was made intraoperatively. One of them had progressed to local peritonitis. Appendicectomy and hernia repair were made at the same time through an inguinal transverse incision, and the postoperative course was uneventful in both. We point out the need to consider acute appendicitis in the differential diagnosis of strangulated right inguinal hernia.

Amyands Hernia: Report of Two Cases

“…Appendectomy adds the risk of infection to an otherwise clean procedure. Most authors recommend reduction of the appendix and mesh hernioplasty if appendix is normal and appendectomy followed by Bassini or Shouldice hernia repair if an inflamed appendix is found [3,9]. Coming to our cases, our first case was Type 2, with appendix being inflamed and we performed appendectomy and herniotomy.…”

“…Acute appendicitis within an inguinal hernia accounts for 0.1% of all cases [2,3]. Inflammation of the appendix is attributed to external compression of the appendix at the neck of the hernia.…”

Amyand’s Hernia: A Case Report

“…Amyand's hernia is three times more common in children than in adults probably because of patent processus vaginalis. 2 The incidence of having a normal appendix within the hernial sac varies from 0.5% to 1%. Only 0.1% of all cases of appendicitis present in an inguinal hernia underscoring the rarity of the condition.…”

Amyand’s Hernia: an Up-to-Date Review of the Literature

“…Besides, the appendix could be used, in the future, for replacement of the extra-hepatic biliary tract, urinary diversion or appendicostomy (Malone procedure) (9,33). Furthermore, during appendicectomy, surgical manipulations in the base of the caecum could increase the recurrence rate of the inguinal hernia, due to detachment in the deep inguinal ring (32). It should be noted that surgical manipulations involving the appendix could trigger secondary acute inflammation (32,33).…”

“…Furthermore, during appendicectomy, surgical manipulations in the base of the caecum could increase the recurrence rate of the inguinal hernia, due to detachment in the deep inguinal ring (32). It should be noted that surgical manipulations involving the appendix could trigger secondary acute inflammation (32,33). This -theoreticalpossibility is minimized, when the procedure is performed laparoscopically (9, 33).…”