New classification of Amyand's hernia, our experience: a retrospective observational study with a literature review.

Abstract

Amyand's hernia (AH) is the name given to the type of hernia in which the appendix is found in a hernial sac. We aimed to share our clinical experience with a literature review for AH. A total of 1,774 inguinal hernias and 13 AH cases were repaired in our clinic between 2009 and 2020. In addition, detailed clinical features about AH were extracted by including unpublished data of 165 cases, which were gathered from the extensive literature on childhood AHs using PubMed, Web of Science, and Cochrane databases. The rate of AH was 0.73% in all inguinal hernias; this rate was 8.6% for incarcerated hernias. The average age was 5.74 ± 7.27 months for AH. Our AH cases were seen in males and on the right side. AH is seen in 97.3% of males according to a review of 69 articles. The average age was 16.78 ± 30.46 months. One hundred sixty-five of the AH cases were on the right (88.7%). The main symptoms were swelling or redness in the inguinal region, pain, fever, and vomiting, along with patients presenting septic or with stercoral fistula. If the appendix is normal and easily reduced, high ligation is sufficient. In cases where reduction is difficult and/or the appendix is inflamed, appendectomy and hospitalization should be performed.