Amyand hernia: a case of an unusual inguinal herniace

Amyand hernia, named for the first person to describe an inguinal hernia containing the vermiform appendix, is an uncommon variant of an inguinal hernia. Presence of the appendix in the sac complicates the management of inguinal hernias. The appendix may be more prone to rupture when contained within a hernia sac, and herniation of an inflamed appendix into the scrotum can mimic an acute scrotum. A 50-year-old man presented with right lower quadrant abdominal pain associated with chills and anorexia. Physical examination revealed right lower quadrant tenderness and a right inguinal mass without associated skin changes. Laboratories were normal. A plain abdominal computed tomography scan for acute appendicitis showed an indirect right inguinal hernia with the appendix contained within the sac, which was incarcerated. Surgical consultation was obtained. The patient taken to the operating room, and his appendix was removed. The hernia was coincidentally repaired, and the patient was discharged soon thereafter. In cases suggestive of acute appendicitis complicating an inguinal hernia, the diagnosis of this unusual variant must be considered.