Perforated Appendiceal Mucocele within an Amyand's Hernia: A Case Report and a Brief Review of Literature

Area of Science:

• Gastroenterology
• Surgical Case Reports
• Abdominal Surgery

Background:

• Amyand's hernia (AH) is a rare inguinal hernia involving the appendix.
• Appendiceal mucocele is a dilated appendix with mucinous material, potentially benign or malignant.
• This report details an exceptionally rare case of a perforated appendiceal mucocele within an AH.

Purpose of the Study:

• To report a rare case of a perforated appendiceal mucocele within an incarcerated Amyand's hernia.
• To describe the clinical presentation, surgical management, and histopathological findings.

Main Methods:

• A case report of a 77-year-old male with an incarcerated right inguinoscrotal hernia.
• Intraoperative findings revealed a perforated, dilated appendix within the hernia sac.
• Surgical management included right hemicolectomy, orchiectomy, and herniorrhaphy.

Main Results:

• The patient presented with an incarcerated hernia containing a perforated, phlegmonous, dilated appendix.
• Histopathology confirmed a perforated benign appendiceal mucocele with phlegmonous appendicitis and fibrinous peritonitis.
• Adjacent structures including the ileum, cecum, colon, and testicle were compromised.

Conclusions:

• This case represents a rare confluence of an incarcerated Amyand's hernia and a perforated appendiceal mucocele.
• The diagnosis was made intraoperatively, necessitating extensive surgical intervention.
• This highlights the importance of considering rare appendiceal pathologies in incarcerated hernias.