Abstract
IntroductionA vermiform appendix in an inguinal hernia, inflamed or not, is known as Amyand's hernia. Here we present a case series of four men with Amyand's hernia.Case presentationsWe retrospectively studied 963 Caucasian patients with inguinal hernia who were admitted to our surgical department over a 12-year period. Four patients presented with Amyand's hernia (0.4%). A 32-year-old Caucasian man had an inflamed vermiform appendix in his hernial sac (acute appendicitis), presenting as an incarcerated right groin hernia, and underwent simultaneous appendectomy and Bassini suture hernia repair. Two patients, Caucasian men aged 36 and 43 years old, had normal appendices in their sacs, which clinically appeared as non-incarcerated right groin hernias. Both underwent a plug-mesh hernia repair without appendectomy. The fourth patient, a 25-year-old Caucasian man with a large but not inflamed appendix in his sac, had a plug-mesh hernia repair with appendectomy.ConclusionA hernia surgeon may encounter unexpected intraoperative findings, such as Amyand's hernia. It is important to be prepared and apply the appropriate treatment.
Highlights
A vermiform appendix in an inguinal hernia, inflamed or not, is known as Amyand’s hernia
According to the surgeon’s descriptions, the patient had “a fistula between the scrotum and thigh” and the operation proved to be “very complicated and perplexing,” as the pathology consisted of a chronically inflamed appendix contained within the inguinal hernia sac, perforated by a previously swallowed pin
Acute appendicitis within an inguinal hernia accounts for 0.1% of all cases [2,3,4,5,6,7]
Summary
A vermiform appendix in an inguinal hernia sac, with or without appendicitis, is called Amyand’s hernia. Case 1 A 32-year-old man, with the clinical appearance of an incarcerated right groin hernia, had acute appendicitis and underwent simultaneous appendectomy and conventional modified Bassini hernia repair. Case 3 A 43-year-old man, with the clinical appearance of a non-incarcerated right groin hernia, with a normal appendix within his hernia sac, had a mesh-plug hernia repair without appendectomy. Case 4 The fourth patient, a 25-year-old man, presented with a 20 cm long but non-inflamed appendix This was fully contained and adhering to his inguinal sac wall, pulling the cecum up to the internal inguinal orifice. The patient underwent a mesh-plug hernia repair along with appendectomy
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