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Left-side incarcerated Amyand's hernia with appendix and caecum provoke by early banana diet: a case report
Supangat1,2,3, Henggar Allest Pratama4, Nanda Eka Sri Sejati4
1Pharmacology Department, Faculty of Medicine, Jember University, Jember, 68121, Indonesia. drsupangat@unej.ac.id.
Insights
Early banana consumption in infants may trigger inguinal hernias, potentially leading to Amyand's hernia (appendix within the hernia sac). This case highlights the risks of early solid food introduction in infants.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Amyand's hernia, the presence of the appendix in an inguinal hernia sac, occurs in 1% of pediatric inguinal hernias.
- Clinical presentation varies with hernia stage, from inguinal mass to bowel obstruction.
Observation:
- A two-month-old infant presented with an incarcerated left inguinal hernia and a history of early banana diet.
- Surgical exploration revealed a left-sided incarcerated Amyand's hernia with appendicitis, cecal excoriation, and a banana mass.
Findings:
- Early introduction of banana as a solid food in infants may be linked to bowel obstruction.
- This case suggests a potential correlation between early banana feeding and the incarceration of inguinal hernias, including Amyand's hernia.
Implications:
- Dietary practices in infants, particularly early introduction of solids like bananas, require careful consideration.
- This case underscores the importance of considering diet in the etiology of pediatric surgical emergencies like incarcerated hernias.
Background:
Amyand's hernia was an unusual condition defined by the presence of an appendix located in the inguinal hernia sac. Its prevalence was 1% of all inguinal hernia in children. The clinical manifestation of Amyand's hernia was depending on hernia's stage, an incarcerated hernia will present with an inguinal mass following by pain and motility disorder. It could lead to abdominal distention in the late stage. The common location of Amyand's hernia was on the right side, the left side was uncommon. Early feeding on infants could provoke symptoms of bowel obstruction (SBO). More than 76% of infants in Java, Indonesia was given banana as solid food in infants before six months old. There is a correlation between the early banana diet and SBO. Amyand's hernia could present as morbidity of early banana diet.
Case Presentation:
We describe a case of two months old infant present with an incarcerated left inguinal hernia and history of early banana diet that performed herniotomy procedure. During the operation, we found left-side incarcerated Amyand's hernia with appendicitis, excoriation caecum, and sticky banana mass.
Conclusion:
This case suggest the possibility of early feeding of banana diet may provoke incarceration of an inguinal hernia and if the incarcerated hernia content contains the appendix, then an Amyand's hernia.
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