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Two cases of intraoperative diagnosed Amyand hernia: Case report and literature review
Souad Ghattas1, Jad El Bitar1, Ribal Aby Hadeer1
1Department of General Surgery - Mount Lebanon Hospital University Medical Center, University of Balamand, Beirut, Lebanon.
Introduction:
Amyand hernia is the presence of an incarcerated vermiform appendix (either inflamed or not) within the hernia sac. This type of hernia is very rare with an incidence reported to be 0.5 to 1 % and even rarer in adults.
Cases Presentation:
We present here two cases of male patients found the have an Amyand Hernia diagnosed incidentally intraoperatively, and managed with appendectomy and mesh herniorrhaphy.
Clinical Discussion:
For the management of this type of hernia, in general, the surgeon should perform an appendectomy with the repair to prevent future herniation or appendicitis, but some opinions differ, and state that when there are no signs of inflammation, it is not required to perform a preventative appendectomy.
Conclusion:
The decision on how to manage depends on multiple factors including inflammation of the appendix, the possibility of abdominal sepsis, and the patient comorbidities. The status of the appendix determines whether to undergo hernia repair with or without mesh.
Insights
Amyand hernia, a rare condition involving the appendix within a hernia sac, requires careful surgical management. Treatment decisions for this rare hernia depend on appendix inflammation and patient factors.
Area of Science:
- General Surgery
- Abdominal Surgery
Background:
- Amyand hernia is a rare condition where the vermiform appendix is found within a hernia sac, occurring in 0.5-1% of hernias.
- This condition is exceptionally rare in adults.
Observation:
- Two incidental cases of Amyand hernia in male patients were diagnosed during surgery.
- Management involved appendectomy and mesh herniorrhaphy.
Findings:
- Surgical management of Amyand hernia typically includes appendectomy to prevent complications.
- There is ongoing discussion regarding the necessity of preventative appendectomy when the appendix is not inflamed.
Implications:
- Management decisions for Amyand hernia hinge on appendix inflammation, sepsis risk, and patient comorbidities.
- The appendix's condition dictates whether mesh is used in hernia repair.
