Amyand's hernia with appendicitis in the children: A delayed diagnosis

Amyand hernia: scrotal pyocele, associated with perforated vermiform appendix and complicated by testicular ischemia in neonate

“…Our patient did not undergo any maneuver to reduce the hernia. It has been noted that both CT scans and ultrasonography can be helpful in providing a preoperative diagnosis [6, 7]. In our patient’s case, we had an ultrasound, which indicated testicular torsion and pyocele.…”

“…The pathophysiology of Amyand’s hernia and its relationship with appendicitis are unknown. Some authors consider it an accidental finding; for others, a decrease in vascularization during incarceration and the maneuver to reduce the hernia result in inflammation of the appendix [6]. Our patient did not undergo any maneuver to reduce the hernia.…”

A case of Amyand's hernia in a preterm infant

“…6 Preoperative manoeuvres to reduce the hernia have also been postulated as a cause. 8,11,13 Neonatal appendicitis occurs in 0,1% of all infantile cases of appendicitis. An Amyand's hernia has been implicated as a cause for neonatal appendicitis in 25-30% of all cases reported in the literature, [6,13,14 however various other causes have also been described.…”

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

“…Losanoff and Basson proposed a classification for Amyand's hernia, setting a therapeutic framework (Table 1) (20,29,30,31 Singal et al refer to the modification of the Losanoff and Basson classification of Amyand's hernia, also known as Rikki modification. A fifth type of Amyand's hernia is added on the latter classification, referred as an incisional hernia through which the vermiform appendix protrudes.…”

“…As a general rule, in case of a non-inflamed appendix, the patient undergoes hernia repair without appendicectomy (12,19,22,31). Researchers sharing this opinion believe that this approach could decrease postoperative complications, as a clean surgery is not converted to a clean-contaminated one.…”