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Appendicitis within an Amyand's hernia: a surprising finding

Corinna Chiong1, Peter Yoon1, Fred Boseto1

  • 1Department of Surgery, Bathurst Base Hospital, Bathurst, Australia.

Journal of Surgical Case Reports
|March 20, 2019
PubMed

Insights

Amyand's hernia, a rare condition, involves the appendix in the hernial sac. This case highlights appendicitis within such a hernia, treated with appendicectomy and repair.

Area of Science:

  • General Surgery
  • Gastroenterology

Background:

  • Amyand's hernia is a rare anatomical condition where the vermiform appendix is located within an inguinal hernia sac.
  • Appendicitis occurring within an Amyand's hernia is exceptionally uncommon, posing diagnostic and surgical challenges.

Observation:

  • A 72-year-old male presented with a painful, irreducible right inguinal lump, indicative of a potential hernia complication.
  • Clinical examination revealed signs suggestive of incarcerated inguinal hernia.

Findings:

  • Surgical exploration confirmed an Amyand's hernia with acute appendicitis.
  • The patient underwent successful open appendicectomy and primary tissue repair of the hernia.

Implications:

  • This case underscores the importance of considering appendicitis in patients with incarcerated inguinal hernias, even in the absence of typical appendicitis symptoms.
  • A staged surgical approach, with initial appendicectomy and repair followed by elective mesh hernioplasty, can be a safe and effective management strategy for complicated Amyand's hernia.

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