Amyand's Hernia Research Articles

A Case of Amyand's Hernia

A Case of Amyand's Hernia

053. Amyand’s Hernia Manifesting as Recurrent Incarcerated Lateral Inguinal Hernia: A Case Report

Background: Amyand’s hernia (AH) is a rare type of inguinal hernia, constituting approximately 1% of all inguinal hernia cases, where the appendix is found within the hernia sac. Typically, patients with AH are asymptomatic and the condition is often diagnosed during surgery. Due to its rarity and nonspecific presentation, diagnosis requires a high index of suspicion and relies heavily on imaging. Surgical intervention is the primary treatment. Here, we present a case of Amyand’s hernia managed surgically at our medium-complexity public hospital. Case: A 39-year-old man presented to the emergency room with an incarcerated right side inguinal hernia without any signs of ischemic complications. He was admitted, and an hernioplasty was performed, as an incidental finding we encountered an Amyand hernia treated without appendectomy and placement of a prosthetic mesh without any complications. During open hernia repair surgery, dense adhesions were found within the hernia sac. Upon releasing the adhesions, the appendix was discovered herniated into the inguinal canal, mildly congested but not inflamed. Consequently, a preperitoneal polypropylene mesh hernioplasty using the Lichtenstein tension-free repair technique was performed along with an appendectomy. The postoperative period was uneventful, and the patient was discharged on the second day. Conclusion: Amyand’s hernia is extremely rare, involving the appendix in the hernia sac, and accounts for 0.4–1% of all inguinal hernia cases. Literature indicates that the incidence of AH is very low, with only 0.1% of cases leading to acute appendicitis due to late presentation and missed diagnosis. Amyand’s hernia represents a small fraction of inguinal hernia cases and is usually diagnosed incidentally during surgery. This condition may remain asymptomatic, presenting similarly to a typical inguinal hernia. Management should be tailored based on the stage of appendiceal inflammation, presence of abdominal sepsis, and patient comorbidities. This individualized approach enables surgeons to effectively handle various presentations of Amyand’s hernia. Laparoscopy can serve both diagnostic and therapeutic roles in managing AH.

S4757 Generalized Peritonitis Induced by a Strangulated Right Amyand's Hernia Containing a Perforated Appendix: A Case Study

S4757 Generalized Peritonitis Induced by a Strangulated Right Amyand's Hernia Containing a Perforated Appendix: A Case Study

Amyand’s Hernia: A Case Report

Amyand's hernia is defined as the presence of the appendix vermiformis (inflamed or non-inflamed) within the inguinal hernia sac. It is seen in approximately 1% of inguinal hernia cases. This extremely rare condition is often diagnosed conventionally, at surgery. However, with the increasing use of computed tomography (CT) and ultrasonography (US) examinations, preoperative diagnosis is also possible. The treatment approach varies depending on whether the appendix inside the hernia sac is inflamed or not. For this reason, imaging examinations are of great importance in making a diagnosis and directing treatment. As a result of imaging examinations in an elderly patient in our clinic, colon, small intestine segments, omentum and appendix were detected in the right inguinal canal. Since the appendix was also located within the hernia sac, the case was called Amyand's hernia. In this article, we wanted to draw attention to Amyand's hernia in general and the place of radiological examination in diagnosis and treatment of this disease.

Amyand's hernia concurrent with appendicitis: A literature review

When the vermiform appendix is inside the hernia sac, an uncommon kind of inguinal hernia known as Amyand's hernia (AH) occurs. Typically, an unintentional discovery discovered during surgery serves as the basis for the diagnosis. Only a tiny percentage of patients with inguinal hernias have AH, and even fewer experience problems with acute ischemia. The referral to general surgical services was due to an inguinal tumor located in the right lower quadrant of our 65-year-old male patient. There may be consequences from ischemia because this was not touch-sensitive. The appendix was removed by open hernioplasty. Treatment for type 1 AH, which this patient has, consists of mesh repair and hernial reduction. Despite not having acute appendicitis, our patient needed an appendectomy due to anatomical variation in their AH, which raised the possibility of hernial incarceration. Because of its size and adhesions inside the hernia, this treatment was also thought to be essential for preventing the recurrence of the hernia. This paper introduces a new method for handling the accidental finding of a type 1 AH. There are few treatment suggestions available for anatomic variations of the AH. The physical characteristics of AH may be included to overcome the drawbacks of the traditional Losanoff and Basson's AH classification methods for AH management and categorization. By using this method. Amyand's hernia occurs when a vermiform appendix is discovered inside an inguinal hernia sac. The objectives of this comprehensive investigation were to gather information on its occurrence, clinical picture, diagnosis, and treatment course.

Left Claudius Amyand Hernia in an Infant: A Case Report

Claudius Amyand's hernia is a rare condition in children. We report a case of Claudius Amyand's hernia in a 3-month-old infant with an untreated simple inguinoscrotal hernia, presenting with signs of incarceration. Incidentally, the appendix was found within the inguinal canal. Management consisted of appendiceal preservation and inguinal hernia repair. The postoperative course was uneventful for our patient.

Amyand's Hernia a form of Inguinal Hernia: A Case Report and Literature Review

Introduction: Amyand hernia (HA) is a form of inguinal hernia considered to be very rare, and this type of hernia has occurred up to 1% of all inguinal hernia cases. In this type of inguinal hernia, the contents of the hernia is the appendix. Most patients with HA often remain asymptomatic and diagnosed intraoperatively. The diagnosis is difficult, surgery is the pillar of management. We report a case of Amyand hernia that was operationally managed in our institution. Case Report: A 50-year-old patient with a normal body mass index (BMI) with a history of right-side reducible inguino-scrotal hernia that has evolved for 4 years, he was admitted for management of elective right inguinal hernia. Two weeks before admission, he noticed worsening pain. Normal abdominal ultrasound. There was no history of abdominal pain and vomiting. The biological assessment was normal. So, with a diagnosis of partially reducible right inguinal hernia, incomplete and indirect, the patient was operated on surgical exploration, we found dense adhesions in the sac, and adhesiolysis was released which revealed a hernia of the appendix in the inguinal canal. The appendix was slightly congested with no signs of inflammation. Therefore, given the uninflated appendix, a hernia cure according to Lichtenstein with an appendectomy was performed. Simple post-operative follow-up. Clinical Conclusion: Amyand’s hernia, is a condition where the appendix is found in the hernia sac, is quite rare, accounting for only 0.4–1% of all instances of inguinal hernia. A review of the literature further emphasizes the rarity of Amyand’s hernia. Moreover, a mere 0.1% of these cases progress to acute appendicitis, often as a result of delayed presentation and overlooked diagnosis. Conclusion: Amyand’s hernia (AH) constitutes a minor percentage of all inguinal hernia cases, and its identification often occurs unexpectedly during surgery. This condition can stay symptom-free and mimic a typical inguinal hernia. .......

Acute Appendicitis on Claudius Amyand's Hernia in a 05-year-old Child: A Case Report

Claudius Amyand's hernia is defined by the incarceration of the vermicular appendix through the hernial sac. The first appendectomy was performed in 1735. It is a very rare condition in children. As a result, the frequency of this condition has not yet been established. We report the case of a 05-year-old child with an inguinal hernia admitted to the emergency department for the management of a painful and inflammatory inguinal-scrotal swelling that had been evolving for less than 6 hours. Management consisted of a conditioning and pre-anaesthetic assessment. Intraoperative exploration revealed a catarrhal appendix in the distal portion, and the surgical procedure consisted of appendectomy with reintegration of the herniated colon and closure of the hernia sac. The postoperative course was straightforward and the clinical outcome was satisfactory after 03 months.

Strangulated Amyand Hernia and Gangrene of Right Testis

Strangulated Amyand Hernia and Gangrene of Right Testis

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

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.

Amyand Hernia on Computerized Tomography: A Rare Case Report

A hernia occurs when an organ or part of it protrudes through the usual surrounding tissue or wall and typically occurs because of weakness in the muscular layer or a congenital/acquired defect. It can be either reducible, meaning the herniated contents can return to the cavity, or irreducible/incarcerated, indicating that they cannot be returned. An incarcerated hernia can lead to strangulation, resulting in a loss of blood supply and the development of gangrene. While the most common type of hernia is inguinal, Amyand hernia is a very uncommon type with an incidence of less than 1%. It can lead to complications like acute appendicitis, which occurs in approximately 0.1% of cases. Pre-operative diagnosis is challenging, and it is often an unexpected discovery, increasingly detected through abdominal CT scans. As a result, CT scans play a crucial role in its management.

Amyand hernia with perforated appendix simulating as testicular torsion in a neonate: A case report

Background: Amyand hernia is defined as the presence of the vermiform appendix within the hernial sac. A perforated appendix is an uncommon complication of Amyand hernia. Rarely it may simulate a testicular torsion. Case Presentation: A twenty-five-day-old male infant presented with right-sided scrotal swelling, exhibiting symptoms of crying, irritability, and poor feeding over a two-day duration. The swelling was non-reducible, confined to the scrotum, and the spermatic cord showed thickening with erythematous scrotal skin. Following preparation, an inguinal incision was made, and an appendectomy and herniotomy were performed. Conclusion: Amyand hernia, a rare type of inguinal hernia, poses challenges in preoperative diagnosis. The occurrence of a perforated appendix is especially rare in neonates with Amyand hernia. Surgical management entails appendectomy through an inguinal incision coupled with meticulous hernia repair.

An unusual case of the Amyand hernia with perforated appendicitis and a sessile serrated lesion within a recurrent inguinal hernia

The Amyand hernia is a rare type of inguinal hernia where the appendix is located within the hernial sac. It is present in less than 1% of inguinal hernias and in 0.13% of cases, it is associated with complications including acute appendicitis and perforation. This case details an 81-year-old female with recurrent Amyand hernia with perforated appendicitis and a sessile serrated lesion. A literature review was conducted to identify existing cases of the Amyand hernia and neoplasm or recurrent inguinal hernia. Fifteen cases of neoplastic appendix within an Amyand hernia were identified in the literature. All cases found acute appendicitis, three of which were perforated. Histology varied from adenocarcinoma, goblet cell, carcinoid, fibroma, and mucinous cystadenoma. There were nine identified cases of Amyand hernia within a recurrent inguinal hernia. Seven of these cases had acute appendicitis, three of which were perforated, whilst one was gangrenous. All cases performed an appendicectomy, and various open techniques were used for hernia repair with or without mesh. The most interesting finding of the literature review was that Amyand hernia is rarely diagnosed pre-operatively, and that there was a high incidence of appendicitis when in the presence of a neoplastic appendix or a recurrent inguinal hernia. This paper highlights the first reported case of an Amyand hernia with a simultaneous neoplasm and recurrent inguinal hernia, which was managed using a laparoscopic approach without hernia repair.

A Rare Combination of Right-sided Richter’s and Amyand’s Hernia

Amyand hernia is a rare form of hernia which is defined by an inguinal hernia containing the appendix. The appendix may or may not be inflamed and in some cases may be incarcerated. Another type of hernia is Richter hernia which occurs when only a portion of the circumference of the bowel is entrapped within a hernia sac. Although having a hernia is one of the most common encounters seen in the surgical field, having the combination of Amyand’s and Richter’s hernia is rarely encountered. We report the rare finding of both types of hernia as well as the finding of a lymph node within the hernial sac in an asymptomatic patient who was presented to the outpatient clinic for routine check-up.

Appendicitis and its associated mortality and morbidity in infants up to 3 months of age: A systematic review.

Although appendicitis is rare in young infants, the reported mortality is high. Primary aim of this systematic review was to provide updated insights in the mortality and morbidity (postoperative complications, Clavien-Dindo grades I-IV) of appendicitis in infants ≤3 months of age. Secondary aims comprised the evaluation of patient characteristics, diagnostic work-up, treatment strategies, comorbidity, and factors associated with poor outcome. This systematic review was reported according to the PRISMA statement with a search performed in Pubmed, Embase and Web of Science (up to September 5th 2022). Original articles (published in English ≥1980) reporting on infants ≤3 months of age with appendicitis were included. Both patients with abdominal appendicitis and herniated appendicitis (such as Amyand's hernia) were considered. Data were provided descriptively. In total, 131 articles were included encompassing 242 cases after identification of 4294 records. Overall, 184 (76%) of the 242 patients had abdominal and 58 (24%) had herniated appendicitis. Two-hundred (83%) of the patients were newborns (≤28 days) and 42 (17%) were infants between 29 days and ≤3 months of age. Either immediate, or after initial conservative treatment, 236 (98%) patients underwent surgical treatment. Some 168 (69%) patients had perforated appendicitis. Mortality was reported in 20 (8%) patients and morbidity in an additional 18 (8%). All fatal cases had abdominal appendicitis and fatal outcome was relatively more often reported in newborns, term patients, patients with relevant comorbidity, nonperforated appendicitis and those presented from home. Mortality was reported in 20 (8%) infants ≤3 months of age and additional morbidity in 18 (8%). All patients with fatal outcome had abdominal appendicitis. Several patient characteristics were relatively more often reported in infants with poor outcome and adequate monitoring, early recognition and prompt treatment may favour the outcome.

970 A Parisian Pain in the Groin; a Case of De Garengeot’s Hernia

Abstract Introduction 77-year-old gentleman presented with a four-day history of a painful right sided irreducible groin swelling. Background of previous bilateral mesh inguinal hernia repair thirty years prior. Differential diagnosis- recurrent incarcerated inguinal hernia. Description Emergency presentation with a painful right sided groin lump with history of previous inguinal hernia repair. Past medical history of AF on rivaroxaban, HTN and BPH. Patient systemically well with an irreducible lump in the right groin. CTAP showed recurrence of hernia in right inguinal region containing fat stranding and a 2cm-sized fluid-filled structure (suspected appendix). Taken to theatre the following day - oblique incision in right groin. Obvious femoral hernia identified. Haemorrhagic fluid and a necrotic appendix contained in hernia sac. Open appendicectomy performed through groin incision and femoral canal plicated using 2.0 prolene. No mesh used due to risk of contamination. Discharged day 2 post-op. Pathology confirmed acute appendicitis. Discussion Extremely rare case presentation. Femoral hernias account for 3% of all hernias and De Garengeot hernias only 1% of all femoral hernias. Furthermore, De Garengeot hernia with acute appendicitis accounts for only 0.01% of femoral hernias and are much more common in females than males with a 4:1 ratio. Femoral hernias are fifteen times more common in patients who have undergone previous inguinal hernia repair with 33% of men and 4% of women with De Garengeot hernia having undergone previous right inguinal hernia repair. Difficult pre-operative diagnosis given rarity with only 30% of cases diagnosed on pre-operative imaging-initial diagnosis Amyand hernia on CT imaging.

Amyand's hernia complicated with cecal necrosis: presentation of a case and surgical treatment

The presence of the vermiform appendix, inflamed or not, within a hernial sac is known as Amyand's hernia (AH). This represents 1 percent of all inguinal hernias and one third of these are associated with acute appendicitis. This presentation is a rare entity and most of the times it presents as a finding during the surgical event. We report a male patient in his fifth decade of life who consulted for a 10-day history of increased volume in the right inguinal region associated with pain and inability to reduce. An exploratory laparotomy was performed that required a right hemicolectomy. AH represents a diagnostic challenge, in most cases it is considered an incidental intraoperative diagnosis. There is no protocolized treatment, however, the inflammatory degree of the appendix is ​​what will guide the surgical approach.

An Amyand’s Hernia with Recurrence: Clinical and Therapeutic Particularities with Literature Review

Fortuitous discovery of an Amyand hernia during surgery in a patient admitted to the emergency room for groin pain likely related to a strangulated inguinal hernia. The aim of this study is to contribute to the understanding of this disease, particularly in terms of diagnosis and optimization of surgical management. Although serious complications have been described, Amyand hernia generally has a good prognosis. However, practitioners must master the clinical and surgical peculiarities of Amyand hernia in order to ensure optimal and adequate treatment of the hernia while avoiding recurrence. Questions remain regarding its pathophysiology, clinical peculiarity, and treatment. More research and evidence are needed, which will be difficult to achieve due to the rarity of Amyand hernia.

Case report for a patient with an inguinal hernia diagnosed with an Amyand's hernia during surgery.

A 4-year-old child was brought to the medical clinic by her mother with a swelling complaint in the right inguinal region. Following clinical diagnosis and imaging tests, an indirect inguinal hernia was found to be present. It was decided to perform surgery on the child, and he was taken to the operating room and given general anesthesia. An incision was made on the right inguinal side, reaching the spermatic cord and the ostium internum, where a hernia sac was found containing the inflamed appendix. The appendix was removed from the edges of the hernia sac, tied off at its base, and cut. Finally, the hernia sac was closed without the use of a mesh, the surgical incision was closed, and the wound was dressed. The diagnosis of inguinal hernia is initially made based on the symptoms presented by the patient, as well as through ultrasound imaging. For surgical management, there is a classification called Losanoff and Basson, which discusses the surgical treatment options necessary for different types of Amyand hernias. The hernia is classified into four types based on the clinical presentation of the patient and the condition of the appendix, and each type has its own treatment. Amyand's hernia is an uncommon condition diagnosed during surgery.

A case of Amyand hernia at the Central Hospital of Yaounde and review of the literature

IntroductionAmyand's hernia is defined as an inguinal hernia, containing the appendix in the hernia sac. It is a rare form of hernia. Its management is increasingly codified.Clinical historyA 5-year-old patient with a non-remarkable past history was brought for consultation with an intermittent inguino-scrotal swelling and discomfort. Clinical examination revealed a non-tender inguino-scrotal swelling with positive transillumination. A conclusion of a communicating hydrocele was made; hence, an indication for surgery. Per operatively, we had as findings the appendix present within, and linked to the hernia sac. We performed an appendectomy and a high ligation of the hernia sac. The post-operative evolution was favourable. Anatomopathological analysis revealed a catarrhal appendix.ConclusionAmyand's hernia remains a rare pathology that can be seen in children with a persistent peritoneo-vaginal canal. Dissection of the hernia sac must be carried out carefully since it is most often discovered intraoperatively and accidental injury to the appendix, which is attached to the wall of the hernia sac can lead to serious complications.