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Amyand's Hernia: Perforated Appendix in an Incarcerated Inguinal Hernia.
Anupam K Gupta1, Oscar A Vazquez1, James El Haddi1
1Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, USA.
Cureus
|May 14, 2020
Summary
Amyand's hernia involves an appendix within an inguinal hernia. This case details an emergency surgery for an incarcerated, inflamed appendix and bowel requiring resection and anastomosis.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Surgery
Background:
- Amyand's hernia is defined as the presence of the appendix within an inguinal hernia, occurring in approximately 1% of all inguinal hernia cases.
- While typically asymptomatic, the appendix can become inflamed or incarcerated within the hernia sac, leading to complications.
Observation:
- A 56-year-old male presented with symptoms of an incarcerated right inguinal hernia.
- Diagnostic laparoscopy was converted to open surgery due to the incarceration of the cecum and terminal ileum.
Findings:
- The incarcerated segment of the bowel was resected, followed by a primary anastomosis.
- The inflamed appendix and purulent material were irrigated, and the hernia defect was intentionally left unrepaired due to an abscess in the inguinal canal.
Implications:
- This case highlights a rare presentation of Amyand's hernia with bowel involvement, necessitating complex surgical intervention.
- Management requires careful consideration of the hernia contents, degree of inflammation, and presence of infection when deciding on hernia defect repair.
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