Vermiform appendix within incisional hernia

Abstract

The vermiform appendix (whether inflamed or not) within a hernia is very rare occurrence. We present the unprecedented case of a normal appendix found within a Pfannenstiel incisional hernia. A diagnostic laparoscopy was performed as appendicitis was suspected. However, the tip of a normal appendix was visualised within a previous Pfannenstiel incision. Laparoscopic appendicectomy was carried successfully and the patient was discharged. The patient later returned for a successful elective laparoscopic incisional hernia repair.

Appendicitis in an incisional hernia sac following renal transplantation: A case report and brief review of the literature

“…Appendicitis within the hernia sac have a variable presentation and do not follow typical manifestations of acute appendicitis. Reported cases in the literature demonstrates similar clinical presentation to incarcerated hernia [6] . On imaging, the appendix appears as a blind-ending tubular structure that arises from the cecum and extends into the hernia sac.…”

“…A few reports have advocated surgical removal of any appendix encountered within an incisional hernia, even in absence of clinical and radiologic evidence of acute appendicitis [16 , 17] . Whereas, some report advocate against surgical intervention in non-inflamed appendix to avoid complications and risk of mesh infection [6] .…”

“…Appendicitis occurring in the incisional hernia is extremely rare [5] . The clinical presentation of an appendicitis in hernial sac varies, and do not present as a typical case of appendicitis, but rather with symptoms of incarcerated hernia [6] . Computed tomography (CT) plays a pivotal role in early diagnosis, however, there is paucity of data on efficacy of CT in diagnosis of herniated appendicitis.…”

Incisional hernia appendicitis: A unique case report

“…Vermiform appendix occupies various positions within the bony pelvis. Amyand originally documented the presence of appendix within external hernias [4] . With the incidence rate of 0.51% of such Amyand hernias, presence of appendicitis within an incisional hernia is even more rare [5] .…”

“…Classic presentation of appendicitis may be absent in cases of incisional hernia appendicitis [4] . Usually, anorexia, nausea and RIF pain are associated with appendicitis [6] .…”