Amyand's hernia-a vermiform appendix presenting in an inguinal hernia: a case series

Area of Science:

• Surgical Case Series
• Hernia Surgery
• Gastrointestinal Surgery

Background:

• Amyand's hernia is defined as the presence of a vermiform appendix within an inguinal hernia, regardless of inflammation.
• This condition is infrequently encountered in surgical practice.

Purpose of the Study:

• To present a case series of four male patients diagnosed with Amyand's hernia.
• To highlight the varied clinical presentations and management strategies for this rare condition.

Main Methods:

• Retrospective analysis of 963 inguinal hernia patients over 12 years.
• Identification and detailed review of four cases of Amyand's hernia.
• Surgical interventions included appendectomy with hernia repair (Bassini or plug-mesh) and plug-mesh repair without appendectomy.

Main Results:

• Amyand's hernia occurred in 0.4% of the studied inguinal hernia cohort.
• Case 1: 32-year-old male with acute appendicitis in an incarcerated hernia underwent appendectomy and Bassini repair.
• Cases 2 & 3: 36 & 43-year-old males with normal appendices in non-incarcerated hernias underwent plug-mesh repair without appendectomy.
• Case 4: 25-year-old male with a large, non-inflamed appendix underwent plug-mesh repair with appendectomy.

Conclusions:

• Amyand's hernia presents surgeons with unexpected intraoperative findings.
• Appropriate surgical preparedness and tailored treatment are crucial for managing Amyand's hernia effectively.