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Revisiting Amyand's Hernia: A 20-Year Systematic Review
Dimitrios K Manatakis1, Nikolaos Tasis2, Maria Ioanna Antonopoulou1
1Second Department of Surgery, Athens Naval and Veterans Hospital, Eptanisou 18, Agia Varvara, Athens, Greece.
World Journal of Surgery
|February 18, 2021
Summary
Amyand's hernia, an appendix protrusion into an inguinal hernia, requires careful surgical decisions. Elective cases may benefit from appendectomy to prevent mesh infection, while acute appendicitis cases dictate repair type based on contamination levels.
Area of Science:
- General Surgery
- Gastrointestinal Surgery
- Hernia Surgery
Background:
- Amyand's hernia involves the appendix protruding into an inguinal hernia.
- Surgical management strategies require careful consideration.
Purpose of the Study:
- To review case reports and series of Amyand's hernia.
- To emphasize surgical decision-making in managing this condition.
Main Methods:
- Systematic review of English literature from 2000-2019.
- Searched PubMed and Embase using keywords: hernia, inguinal, appendix, appendicitis, Amyand.
- Included 231 studies describing 442 patients.
Main Results:
- The study analyzed 442 patients (57.5% adults, 42.5% children; 91% males).
- In elective repairs, 38.5% had appendectomy, 61.5% simple reduction; 88% of adults used mesh repair.
- Acute cases (76% complications, 12% appendicitis) involved 79% appendectomy; mesh use varied by procedure; mortality 1.8%, morbidity 9.2%.
Conclusions:
- Elective Amyand's hernia may warrant appendectomy to prevent mesh infection if fecal spillage is avoided.
- For acute appendicitis, mesh repair is feasible in clean fields; contaminated fields favor endogenous tissue repair.
