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Complicated Amyand's hernia

Q Goolam1, P M Wondoh1, W H Hansen1

  • 1Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, South Africa.

South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
|May 20, 2026
PubMed
Abstract

Insights

Amyand's hernia, a rare condition with the appendix in an inguinal hernia, can become complicated. This case involved a ruptured appendix with an abscess, requiring urgent surgery and highlighting the importance of CT imaging and tailored surgical approaches.

Area of Science:

  • Surgical Case Report
  • Abdominal Wall Surgery
  • Gastrointestinal Surgery

Background:

  • Amyand's hernia is defined as the presence of the vermiform appendix within an inguinal hernia sac.
  • It is a rare condition, with reported incidences varying between 0.3% and 3.2% of all inguinal hernias.
  • Complicated Amyand's hernia, involving perforation or strangulation, necessitates prompt diagnosis and management.

Purpose of the Study:

  • To report a case of complicated right-sided Amyand's hernia with a perforated appendix and scrotal abscess.
  • To emphasize the diagnostic utility of computed tomography (CT) in atypical groin infections.
  • To underscore the importance of multidisciplinary collaboration and individualized surgical strategies for complex cases.

Main Methods:

  • A case study approach was used, detailing the clinical presentation, diagnostic imaging, and surgical management.
  • Computed tomography (CT) scan was crucial for preoperative evaluation.
  • Multidisciplinary team involvement (surgery, radiology) was integral to management.

Main Results:

  • Imaging revealed a ruptured hernia sac containing a perforated appendix with an appendicolith.
  • A significant rim-enhancing scrotal abscess was identified.
  • Urgent surgical intervention was required for management.

Conclusions:

  • Computed tomography (CT) is invaluable for diagnosing atypical groin sepsis and guiding management.
  • Multidisciplinary care and timely surgical intervention are critical for complicated Amyand's hernia.
  • Individualized operative strategies are essential for managing perforation and associated soft-tissue infections in Amyand's hernia.
Keywords:
Amyand herniaappendicitisinguinal hernianecrotising fasciitis

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