Implications of the presence of the vermiform appendix inside an inguinal hernia (Amyand’s hernia): a systematic review of the literature

Papaconstantinou, Dimitris; Garoufalia, Z.; Kykalos, Stylianos; Nastos, Constantinos; Tsapralis, Dimitrios; Ioannidis, Orestis; Michalinos, Adamantios; Chatzimavroudis, Grigoris; Schizas, Dimitrios

doi:10.1007/s10029-020-02215-5

Cited by 22 publications

(31 citation statements)

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“…Recently, a systematic review indicated that CT was the de nitive diagnostic modality in patients with preoperative diagnosis. [17] In our six cases, four patients were diagnosed with appendicitis and inguinal hernia by CT whereas two patients were diagnosed with inguinal hernia by ultrasonography. However, the diagnosis of Amyand's hernia of these patients was obtained during surgery.…”

Section: Discussionmentioning

confidence: 73%

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Amyand’s Hernia: A Ten-year Experience With 6 Cases

Gao

Zhang

et al. 2021

Preprint

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Purpose: Amyand’s hernia is a rare hernia defined as an inguinal hernia that contains the appendix within the hernia sac. Current treatment of Amyand’s hernia remains controversial. Our study retrospectively reviewed 6 cases of Amyand’s hernia, aiming to provide a reference for the surgical treatment of Amyand's hernia.Methods: Six patients diagnosed with Amyand’s hernia from September 2010 to May 2020 were retrospectively enrolled in our study. We summarized clinical data of six patients including the chief complaint, physical examinations, laboratory examinations, imaging examinations, surgical methods, and postoperative treatments and outcomes.Results: The diagnosis of six cases with Amyand’s hernia was made during surgery. Two patients had normal appendixes whereas the remaining four patients had inflamed appendixes. Two patients with normal appendix received tension-free mesh repair through the inguinal incision. Among those with inflamed or perforated appendixes, two received mesh repair and the other two did not. The discharge time after surgery of six patients was 9.8±6.1 days. One patient suffered from an incision infection. No additional postoperative complications were detected. Conclusions: Computed tomography and ultrasonography are helpful but limited in the definite diagnosis of Amyand’s hernia. The presence of a normal appendix does not require to be resected, but appendicectomy is necessary if the appendix is inflamed. The treatment of Amyand's hernia should be tailored based on the patient's condition and the type of Amyand's hernia.

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Section: Discussionmentioning

confidence: 73%

“…As for the perforated appendix, the synthetic mesh repair should be avoided. Moreover, mesh repair should be deferred if the inguinal canal had severe in ammation [17]. In our view, mesh repair is recommended when a non-in amed appendix is discovered during herniorrhaphy.…”

Section: Discussionmentioning

confidence: 93%

Amyand’s Hernia: A Ten-year Experience With 6 Cases

Gao

Zhang

et al. 2021

Preprint

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“…Therefore, laparoscopic surgery can function as a diagnostic and therapeutic approach. Recently, a systematic review indicated that CT was the definitive diagnostic modality in patients with preoperative diagnosis [ 17 ]. In our six cases, four patients were diagnosed with appendicitis and inguinal hernia by CT whereas two patients were diagnosed with inguinal hernia by ultrasonography.…”

Section: Discussionmentioning

confidence: 99%

“…As for the perforated appendix, the synthetic mesh repair should be avoided. Moreover, mesh repair should be deferred if the inguinal canal had severe inflammation [ 17 ]. In our four cases of mesh repair, polypropylene and polylactic acid composite mesh were used.…”

Section: Discussionmentioning

confidence: 99%

Amyand’s hernia: a 10-year experience with 6 cases

Gao

Zhang

et al. 2021

BMC Surg

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Purpose Amyand’s hernia is a rare hernia defined as an inguinal hernia that contains the appendix within the hernia sac. Current treatment of Amyand’s hernia remains controversial. Our study retrospectively reviewed 6 cases of Amyand’s hernia, aiming to provide a reference for the surgical treatment of Amyand's hernia. Methods Six patients diagnosed with Amyand’s hernia from September 2010 to May 2020 were retrospectively enrolled in our study. We summarized clinical data of six patients including the chief complaint, physical examinations, laboratory examinations, imaging examinations, surgical methods, and postoperative treatments and outcomes. Results The diagnosis of six cases with Amyand’s hernia was made during surgery. Two patients had normal appendixes whereas the remaining four patients had appendicitis. Two patients with normal appendix received tension-free mesh repair through the inguinal incision. Among those with inflamed or perforated appendixes, two received mesh repair and the other two did not. The discharge time after surgery of six patients was 9.8 ± 6.1 days. One patient suffered from a wound infection. No additional postoperative complications were detected. Conclusions Computed tomography and ultrasonography are helpful but limited in the definite diagnosis of Amyand’s hernia. The presence of a normal appendix does not require to be resected, but appendicectomy is necessary if the appendix is inflamed. The treatment of Amyand's hernia should be tailored based on the patient's condition and the type of Amyand's hernia.

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“…The majority of cases are right sided but case reports have described occurrence in the left side of the abdomen [ 3 ]. Their clinical presentation is varied, ranging from asymptomatic as in our case, through to presentation as an incarcerated inguinal hernia [ 4 ]. Uncommonly, Amyand’s hernia can mimic acute scrotal pathology such as torsion or abscess [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Acute appendicitis located within Amyand’s hernia—a complex case with concurrent acute cholecystitis

O’Connor

John

Sabri

2020

Journal of Surgical Case Reports

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Amyand’s hernia is the presence of the vermiform appendix within an inguinal hernia sac. It is rare, and even rarer is the presence of acute appendicitis within the sac. It presents in a variety of different ways and often is only diagnosed intra-operatively. We present the case of a 90 year old male with extensive co-morbidities presenting with right upper quadrant pain, who on computed tomography scan of the abdomen, had acute cholecystitis alongside acute appendicitis within Amyand’s hernia. Ultimately given his co-morbidities, a conservative approach with prolonged antibiotic therapy was adopted, with a successful outcome. This case highlights that although classifications for treatment of Amyand’s hernia exist, careful clinical assessment is warranted in each case to ensure optimal outcome based upon individual circumstances.

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Implications of the presence of the vermiform appendix inside an inguinal hernia (Amyand’s hernia): a systematic review of the literature

Cited by 22 publications

References 50 publications

Amyand’s Hernia: A Ten-year Experience With 6 Cases

Amyand’s Hernia: A Ten-year Experience With 6 Cases

Amyand’s hernia: a 10-year experience with 6 cases

Acute appendicitis located within Amyand’s hernia—a complex case with concurrent acute cholecystitis

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