Amyand's Hernia Research Articles

Left sided amyand‘s hernia.

Amyand hernia is defined as hernia containing appendix as content which can range from being normal or inflamed to being gangrenous and perforated. Its occurrence is three times commoner in infants and it occurs more frequently on right side. Exact surgery to be performed in such cases is subject to the type of amyands hernia present ranging from herniorraphy and hernioplasty to laparotomy. Herein, we report the unusual case of a 70years old man who presented with left sided amyands hernia. Conclusion: Hernia is defined as protrusion of a viscus or part of viscus through an abnormal opening in the wall of its containing cavity. Inguinal hernia is the most commonly occurring variety usually containing gut or omentum. Amyand’s hernia is a rare variety of inguinal hernia comprising 1% of all presentations.1 Its defined by presence of appendix as its content which can be either normal or inflamed.2 Its three times commoner in infants and occurs more on right side.3 Here we report a unique case of left sided Amyand’s hernia diagnosed per operative in seventy year old man.

Therapeutic approach for Amyand’s hernia; a case report

In very few cases stated in the literature, the vermiform appendix might be contained in a hernial sac. This distinctive pathology is described as Amyand's hernia and has the very small occurrence of about 1%. We report the case of a 62-year-old man that presented for a reducible tumoral mass located in the right inguinal region. Amyand’s hernia was the intraoperative diagnostic. We performed hernioplasty (using the Lichtenstein tension-free mesh repair with a composite polypropylene mesh) without appendectomy. This case matches the type 1 Lossanoff and Basson’s classification and has no facile management. Due to the clinical specificities of each case that presents with defining features of an Amyand’s hernia, surgical management depends on the recommendations stated in the literature, as well as the surgeon’s judgment based on experience.

Influence of Contents in Manual Reduction of Incarcerated Inguinal Hernia in Neonates and Infants

Background: Incarceration of the intestine is frequently seen in inguinal hernia in infants below one year of age. Most of the cases are seen in neonates below the age of one month. Manual reduction is the first line of treatment in cases with an incarcerated inguinal hernia in neonates and infants before they are operated upon. If the reduction is successful, then surgical repair is performed after 48 hours. It was observed that in some cases of incarceration manual reduction fails. Our observation is that in the cases where manual reduction fails, the nature of contents of hernia sac play an important role. Objective: To identify the nature of the contents of incarcerated inguinal hernia sac in neonate and infants in whom manual reduction was unsuccessful. Study Design: Observational study. Duration: January 2016 to June 2018. Setting: Department of Pediatric Surgery, Allied Hospital, Faisalabad Medical University Faisalabad and Faisal Hospital, Canal Road, People`s Colony, Faisalabad. Methodology: All male & female neonates and infants presenting with an incarcerated inguinal hernia were included in this study. Cases with other anomalies having incarcerated inguinal hernia were excluded from this study i.e. anorectal malformations, spina bifida, babies with ventriculoperitoneal shunts etc., Informed consent was obtained from their parents. Results: There were 72 cases with age ranging between 36/40 weeks to one year. There were 62 males and 10 females. Manual reduction was performed in male babies only. Out of 62 male babies, 6 were premature, 40 were neonates and 16 were infants. Babies with failed manual reduction underwent immediate surgery. In the 6 preterm babies’ manual reduction was successful. Manual reduction was successful in 42 cases. In the 13 cases who had to be operated upon caecum alone or accompanied with the appendix was found on the right side. In one case Meckel's diverticulum with rim of ileum was found on right side. On the left side caecum with appendix was seen in two and in the other 4 a loop of sigmoid colon full with semisolid stool was present. The gut was viable in all cases and was reduced manually. Conclusion: Amyand hernia found major cause of failed manual reduction along with impacted stool in sigmoid colon.

Combined Type II Amyand's hernia and sliding hernia: A rare presentation of an unusual type of inguinal hernia

Repair of inguinal hernia is one of the most common procedures in general surgical practice. Amyand's hernia is an unusual condition that entails the presence of the appendix in the hernial sac. In this case, we present a rare combination of Type II Amyand's hernia and sliding hernia that was discovered during elective hernial repair in a male patient. The inflamed appendix was removed, and tension-free Lichtenstein repair was performed. Postoperative recovery was uneventful with no recorded complications or recurrence of hernia. Amyand's hernia is usually diagnosed intraoperatively. The association of a sliding component with Amyand's hernia did not alter the management plan. The use of synthetic mesh in Type II Amyand's hernia is safe and feasible, despite the recommendation to avoid prosthetic repair in this type of hernia.

Right-sided Amyand's hernia with cecal perforation and acute appendicitis

Inguinal hernia repair is one of the most common surgeries performed in the department of general surgery throughout the world. However, the presence of a vermiform appendix in the hernial sac, also known as Amyand's hernia, along with a perforated cecum is very rare. We report the case of an elderly male presenting to the surgery emergency with a strangulated, large, right-sided inguinal hernia containing perforated cecum and vermiform appendix as contents in the sac. Resection of the ileocecal segment and side-to-side ileocolic anastomosis of the bowel was performed. Anatomical repair of the hernia was done without the use of mesh.

Laparoscopic Treatment of a De Garengeot Hernia – Case Report and Review of Literature

De Garengeot hernia is defined as femoral hernia containing appendix. It’s an extremely rare occurrence occurring in 0.5% to 3% of femoral hernia cases, with a female: male ratio is 6: 1. We report the case of a 71 years old female patient, who presented an incarcerated right femoral hernia. We performed an explorative laparoscopy with the visualisation of the appendix. The appendix was normal. An intraabdominal reduction of the appendix and the treatment of the hernia by TAPP technique was performed. De Garengeot hernia can be can be a unusal discovery during surgery. The differential diagnostic is with Amyand hernia, which is an incarceration of the appendix in an inguinal hernia. Due to the low occurence of this pathology the explorative laparoscopy may be a valid technique for diagnostic and treatment. In case of acute appendicitis, the use of the mesh is not formally recommended. The laparoscopic treatment of De Garengeot’s hernia is feasible even in emergency setting. If the appendix is inflammatory the appendectomy is mandatory.

Amyand's hernia with perforated appendix complicated by necrotizing fasciitis.

Amyand's hernia with perforated appendix complicated by necrotizing fasciitis.

An unusual inguinal hernia presentation in an infant: Amyand's hernia with acute appendicitis

Amyand's hernia is a rare condition defined as the presence of appendix vermiformis within the hernia sac, and it constitutes 1% (0.19-1.7%) of all inguinal hernias. Inflammation of the appendix within the inguinal sac is rarer, comprising 0.1% (0.07-0.13) of all Amyand’s hernia cases. Although the clinical presentation of the disease varies depending on the inflammation of the appendix, the diagnosis is usually made during the operation. We herein present a 2-month-old male patient who underwent appendectomy during right inguinal herniotomy after visualization of the inflamed appendix adhering to the wall of the hernia sac.

Hernia de Amyand, presentación de un caso

Introducción: Hernia de Amyand es un hallazgo donde el apéndice con o sin inflamación se encuentra en el saco de una hernia inguinal. La prevalencia es muy baja se describe entre el 0.4% y 0.13% de todas las hernias inguinales, mientras que en los niños podría alcanzar el 1%.
 Objetivo: Describir un caso clínico de de hernia de Amyand.
 Material y métodos: Se realizó un estudio descriptivo, retrospectivo, presentación de caso clínico sobre de hernia de Amyand.
 Resultados: Se describe el caso de un paciente masculino de 54 años de edad con antecedentes de masa en región inguinal derecha, que ha ido aumentando de tamaño, desde aproximadamente 1 año de evolución, acompañado de dificultad a la deambulación, al acudir a consulta externa de cirugía en la exploración física en región inguinal derecha se evidenció masa de más o menos 3 centímetros de diámetro, reductible, en la paraclínica rangos normales, fue llevado al quirófano para reparación laparoscópica con diagnóstico de hernia inguinal derecha, donde se evidenció hernia inguinal derecha con saco herniario con contenido de apéndice cecal, condición que se conoce con el nombre de hernia de Amyand.
 Conclusiones: Al evidenciar un paciente con hernia de Amyand que no es un caso común, cuando se asocia a apendicitis la prioridad es la realización de la apendicetomía y en segundo lugar la reparación del defecto herniario de la pared, con malla protésica, aunque sigue siendo controversial ante la posibilidad de infección local por apendicitis aguda, a pesar de ello se implementó esta opción terapéutica con éxito

Pediatric amyand hernia : case report in Sanjiwani Gianyar Hospital Bali-Indonesia

Introduction: Amyand’s hernia (AH) is defined as protrusion of the vermiform appendix in an inguinal hernia sac, and incidence was reported only 1% of all inguinal hernias. This study aimed to share the experience of inguinal hernia repair with appendectomy for Pediatric case with non inflamed appendices.Case: A 2-year-old male came to the emergency department with a history of irreponible lump along with right scrotal tender 6 hours before admission and progressively increased. There is no specific sign of obstruction,dehydration or infection. His lump already presented since new born but with age progression the reponible complain become more frequently. Based on clinical presentation this patient did open repair of hernia as diagnostic and therapeutic, identification of appendix was non-inflamed appendix inside right scrotum, no sign of incarcerated strangulated of perforated. No Complication was reported until two-month post-operative. Surgical correction is already done with non-complication post-operative care for 2 month period.Conclusion: Pediatric Amyand Hernia is rare case (1% from all inguinal hernia) diagnostic and therapeutic could be very challenging. Open herniotomy repair and appendectomy for this case was taken with satisfying outcome.Keywords: pediatric, inguinal hernia, appendectomy.

Fournier's gangrene as Amyand's hernia complication

Introduction: Fournier’s gangrene is a rare but fast deteriorating and serious condition with high mortality. In most cases, it is characterized as necrotizing fasciitis of the perineum and external genitals. Amyand’s hernia is a rare condition where the appendix is contained in the sac of an inguinal hernia. Inflammatory alterations in the appendix account only for 0.1 % of the cases when Amyand’s hernia is verified. Fournier’s gangrene as a complication of a late diagnosis of appendicitis located in the inguinal canal is described in the literature as rare case reports. Case report: The case report of a 70-year-old patient with Fournier’s gangrene resulting from gangrenous appendicitis of Amyand’s hernia. Conclusion: Fournier’s gangrene as a complication of Amyand’s hernia is a rare condition. Only sporadic case reports thereof can be found in the literature. Because of the rarity of this pathology and the lack of randomized controlled studies, it is difficult to determine the optimal treatment according to the principles of evidence-based medicine. An appropriate approach for this condition appears to be the combination of guidelines developed in Amyand’s therapy according to Losanoff and Basson, along with the recommended “gold standard” therapy for Fournier’s gangrene. This means early and highly radical surgical debridement, adequate antibiotic therapy and intensive care.

Obstructed Left Amyand’s Hernia in a Seven Month Male Infant with Meatal Stenosis: Case Report and Review of Literature

Left Amyand Hernia (AH) is a very rare form of inguinal hernia. It presents commonly as an incarcerated inguinal hernia and intraoperative diagnosis is usually the rule. This is a report of a 7 months old male infant presenting with bilateral inguinal hernia, including a complicated left AH, with associated mobile caecum and meatal stenosis. He had bilateral herniotomy, transhernial appendectomy and meatotomy and did well post-operatively. A comprehensive comparative review of all 35 reported cases of left AH in the literature was undertaken alongside this report.

Obstructed Left Amyand’s Hernia in a Seven Month Male Infant with Meatal Stenosis: Case Report and Review of Literature

Left Amyand Hernia (AH) is a very rare form of inguinal hernia. It presents commonly as an incarcerated inguinal hernia and intraoperative diagnosis is usually the rule. This is a report of a 7 months old male infant presenting with bilateral inguinal hernia, including a complicated left AH, with associated mobile caecum and meatal stenosis. He had bilateral herniotomy, transhernial appendectomy and meatotomy and did well post-operatively. A comprehensive comparative review of all 35 reported cases of left AH in the literature was undertaken alongside this report.

Obstructed Left Amyand’s Hernia in a Seven Month Male Infant with Meatal Stenosis: Case Report and Review of Literature

Left Amyand Hernia (AH) is a very rare form of inguinal hernia. It presents commonly as an incarcerated inguinal hernia and intraoperative diagnosis is usually the rule. This is a report of a 7 months old male infant presenting with bilateral inguinal hernia, including a complicated left AH, with associated mobile caecum and meatal stenosis. He had bilateral herniotomy, transhernial appendectomy and meatotomy and did well post-operatively. A comprehensive comparative review of all 35 reported cases of left AH in the literature was undertaken alongside this report.

An Unexpected Case of Right Iliac Fossa Pain: Amyand Hernia

An 84-year-old man presented with a tender right groin lump of a few days’ duration, which was associated with nausea. Physical examination revealed discomfort on deep palpation in the right groin, with no obvious cough impulse or abdominal peritonism. Blood tests and abdominal radiographs were unremarkable. Computed tomography scan demonstrated a dilated fluid-filled appendix with fat stranding, which was consistent with acute appendicitis (Figures A–D). Interestingly, the appendix had herniated through the deep inguinal ring, resulting in an amyand hernia (AH).

A Case Report of Amyand's Hernia in a 55-year-old Saudi Male

A Case Report of Amyand's Hernia in a 55-year-old Saudi Male

Left sided obstructed Amyand’s hernia: a rare case report

Amyand's hernia is a rare form of an inguinal hernia (less than 1% of inguinal hernias) which occurs when the appendix is a part of hernial sac. Because of anatomical position of the appendix, it is most commonly found in the right sided hernial sac and it can also be accompanied by the caecum and/or right colon. In rare case, Amyand’s hernia can appear on the left side also. Here we report a case of left sided amyand’s hernia with acute perforated appendicitis in a 58 years old male patient at GMERS hospital, Dharpur, Patan, Gujarat, India.

Spontaneous evisceration of small bowel in Amyand's hernia: a case report.

Spontaneous evisceration of small bowel in Amyand's hernia: a case report.

Amyand hernia repair with mesh and appendectomy

BackgroundAmyand hernias have been described in case reports in the literature and are a rare occurrence in the career of a surgeon. Their management is even less well described and often poses problems in the management of repair due to concerns with contamination associated with appendectomy. Here, we describe a patient with an Amyand hernia seen on CT imaging preoperatively, who underwent appendectomy along with a lightweight mesh plug repair of his hernia.Case presentationAn 88-year-old male presented with a right groin bulge and underwent preoperative imaging which indicated the presence of his appendix within his hernia. He was taken to the operating room electively where an appendectomy was performed due to significant chronic inflammatory changes. A lightweight mesh plug was used to repair the hernia to prevent recurrence. He did well post operatively without any complications.ConclusionsA review of the literature supports the use of mesh repair in these of hernias even with appendectomy at the time of the hernia repair. This will guide surgeons who encounter this clinical rarity in their practice.

Preoperatively Diagnosed Case of Amyand Hernia and Fish Bone Penetration of the Appendix Treated with Laparoscopic Appendectomy

症例は83歳の男性で，1か月前からの右鼠径部腫瘤を主訴に当科に紹介となった．超音波検査，腹部CTで鼠径ヘルニアの内容が虫垂であるAmyand hernia，虫垂魚骨穿通と診断した．急性腹症の所見はなく，外来での経過観察となった．1週間後も同様の所見を認め，待機的に腹腔鏡下虫垂切除術を行った．ヘルニア囊への虫垂の癒着があったが，ヘルニア囊を内反させることで虫垂および魚骨を切除することができた．鼠径ヘルニアに対する手術希望はなく，ヘルニア根治術は行わず終診となった．Amyand hernia，虫垂魚骨穿通はともにまれであり，術前に診断されることは少なく開腹下に緊急手術されることが多い．今回，Amyand herniaと虫垂魚骨穿通を術前診断し，待機的に腹腔鏡下虫垂切除術を行った症例を経験したので報告する．