Case series on different presentations of Amyand's hernia

Abstract

A vermiform appendix in an inguinal hernia is known as Amyand's hernia. The incidence of having a normal appendix within the hernia sac varies from 0.5% to 1%, whereas only 0.1% of cases complicate into acute appendicitis, underscoring the rarity of the condition. This is a case series of three cases with different presentations and their management. The first case is of a 42-year-old male who was admitted as a routine case of a right-sided indirect inguinal hernia, with a history of occasional pain in the swelling. On surgical exploration of the sac, contents of the hernia sac included omentum and an acutely inflamed appendix with the appendix densely adherent to the hernia sac. Appendicectomy was performed and a herniotomy was done. A herniorrhaphy was performed by modified Bassini repair. The second case is of a 28-year-old young male who presented with a right-sided indirect inguinal hernia. He had no specific complaints associated with the hernia. He was operated under local anesthesia and intraoperatively in the hernia sac, appendix was an incidental finding and an appendicectomy was not performed. The third case is of a 58-year-old man who presented to the emergency with an obstructed hernia. The patient was operated upon in the emergency operation room, and on opening the sac, there was serosanguineous collection and the cecum along with the inflamed appendix. Appendicectomy was done without stump inversion. The superficial inguinal ring was found to be constricting the neck of hernia sac, which was divided. Routine herniotomy and herniorrhaphy was done by modified Bassini method.