1
|
The SML, The AMH, Derikx JPM, Bakx R, Visser DH, de Meij TGJ, Ket JCF, van Heurn ELW, Gorter RR. Appendicitis and its associated mortality and morbidity in infants up to 3 months of age: A systematic review. Health Sci Rep 2023; 6:e1435. [PMID: 37680208 PMCID: PMC10480420 DOI: 10.1002/hsr2.1435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 05/29/2023] [Accepted: 07/07/2023] [Indexed: 09/09/2023] Open
Abstract
Background and Aims 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. Methods 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. Results 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. Conclusion 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.
Collapse
Affiliation(s)
- Sarah‐May M. L. The
- Department of Paediatric Surgery, Emma Children's Hospital Amsterdam UMCUniversity of Amsterdam & Vrije UniversiteitAmsterdamThe Netherlands
- Amsterdam Reproduction and Development Research InstituteAmsterdamThe Netherlands
| | - Anne‐Fleur M. H. The
- University of GroningenUniversity Medical Centre GroningenGroningenThe Netherlands
| | - Joep P. M. Derikx
- Department of Paediatric Surgery, Emma Children's Hospital Amsterdam UMCUniversity of Amsterdam & Vrije UniversiteitAmsterdamThe Netherlands
- Amsterdam Gastroenterology and Metabolism Research InstituteAmsterdamThe Netherlands
| | - Roel Bakx
- Department of Paediatric Surgery, Emma Children's Hospital Amsterdam UMCUniversity of Amsterdam & Vrije UniversiteitAmsterdamThe Netherlands
- Amsterdam Gastroenterology and Metabolism Research InstituteAmsterdamThe Netherlands
| | - Douwe H. Visser
- Department of Neonatology, Emma Children's Hospital Amsterdam UMCLocation University of AmsterdamAmsterdamThe Netherlands
| | - Tim G. J. de Meij
- Amsterdam Reproduction and Development Research InstituteAmsterdamThe Netherlands
- Amsterdam Gastroenterology and Metabolism Research InstituteAmsterdamThe Netherlands
- Department of Paediatric Gastroenterology, Emma Children's Hospital Amsterdam UMCLocation University of AmsterdamAmsterdamThe Netherlands
| | | | - Ernest L. W. van Heurn
- Department of Paediatric Surgery, Emma Children's Hospital Amsterdam UMCUniversity of Amsterdam & Vrije UniversiteitAmsterdamThe Netherlands
- Amsterdam Reproduction and Development Research InstituteAmsterdamThe Netherlands
- Amsterdam Gastroenterology and Metabolism Research InstituteAmsterdamThe Netherlands
| | - Ramon R. Gorter
- Department of Paediatric Surgery, Emma Children's Hospital Amsterdam UMCUniversity of Amsterdam & Vrije UniversiteitAmsterdamThe Netherlands
- Amsterdam Reproduction and Development Research InstituteAmsterdamThe Netherlands
- Amsterdam Gastroenterology and Metabolism Research InstituteAmsterdamThe Netherlands
| |
Collapse
|
2
|
Hernández-López UDJ, Vargas-Buelvas A, Muñoz-Murillo WJ, Muñoz-Murillo KL, Nuñez-Rojas G, Rahman S. Bilateral congenital inguinal hernia with right-sided Amyand's hernia in a premature twin: Case report and a summary of clinical presentations, management and outcomes in neonates and infants with Amyand's hernia. Int J Surg Case Rep 2021; 88:106505. [PMID: 34656928 PMCID: PMC8523876 DOI: 10.1016/j.ijscr.2021.106505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/10/2021] [Indexed: 11/01/2022] Open
Abstract
INTRODUCTION AND IMPORTANCE Congenital hernias occur 70% on the right side, 25% on the left side, and approximately 5% bilaterally. The finding of a congenital Amyand's hernia is of interest, especially in patients who do not present risk factors associated with connective tissue disorders, ascitic conditions, fetal developmental disorders or any condition that increases abdominal pressure. CASE PRESENTATION Male patient, 6 months old, was brought to the pediatric surgery department due to a visible mass in the bilateral inguinal region, which protruded with crying. The parents report that he was a 36-week preterm, low birth weight, monochorionic monoamniotic twin with bilateral congenital inguinal hernia. An open herniorrhaphy was performed, showing a left communicating hydrocele with an indirect left inguinal hernia and right communicating hydrocele with indirect inguinal hernia containing cecal appendix with no signs of inflammation. CLINICAL DISCUSSION The most common clinical presentation is the presence of a reducible or irreducible mass, erythema and/or inguino-scrotal edema, irritability manifested by crying and recurrent pain in older infants. This condition may be associated with cryptorchidism, intrauterine structural developmental disorder, and the presence of fistulas. Appendectomy and traditional hernia reduction are the most common surgical approach. The evolution of this condition is favorable with extremely low complication rates. CONCLUSION Amyand's hernia in the neonate is a rare presenting condition, which frequently involves nearby structures with risk of inflammation, incarceration and perforation, so repair should be performed early.
Collapse
Affiliation(s)
| | - Audrey Vargas-Buelvas
- Department of Medicine, Universidad de Cartagena, Cra. 50 #24-120, Cartagena, Colombia
| | | | | | - Gian Nuñez-Rojas
- Medical and Surgical Research Center, School of Medicine, Universidad de Cartagena, Cra. 50 #24-120, Cartagena, Colombia
| | - Sabrina Rahman
- Department of Public Health, Independent University-Bangladesh, Dhaka, Bangladesh.
| |
Collapse
|
3
|
Omran A, Gawrieh BS, Abdo A, Ali Deeb M, Khalil MA, Shater W. Amyand hernia: scrotal pyocele, associated with perforated vermiform appendix and complicated by testicular ischemia in neonate. J Surg Case Rep 2019; 2019:rjz265. [PMID: 31548875 PMCID: PMC6748709 DOI: 10.1093/jscr/rjz265] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 08/02/2019] [Accepted: 08/13/2019] [Indexed: 01/24/2023] Open
Abstract
The presence of vermiform appendix in an inguinal hernia sac is known as Amyand’s hernia. This research paper examines the case of a 28-day-old Syrian male presented with a history of an infected right-sided hydrocele from the age of 14 days. Upon admission, ultrasonography was reported as a right testicular torsion. Accordingly, emergency surgical exploration was performed, and by exposing the spermatic cord fascia, 7 mL of pus was drained, revealing the cecum and perforated appendix lying beside the right testis, which showed evidence of ischemia and bluish discoloration.
Collapse
Affiliation(s)
- Ammar Omran
- Pediatric Surgery Department, Tishreen University Hospital, Lattakia, Syria
| | | | - Aras Abdo
- Pediatric Surgery Department, Tishreen University Hospital, Lattakia, Syria
| | - Mohammad Ali Deeb
- Pediatric Surgery Department, Tishreen University Hospital, Lattakia, Syria
| | | | - Waseem Shater
- Pediatric Surgery Department, Tishreen University Hospital, Lattakia, Syria
| |
Collapse
|
4
|
Katsogridakis E, Pokusevski G, Byrne P. Acute appendicitis presenting as a complicated inguinal hernia: a case of left-sided Amyand's hernia in an elderly man. J Surg Case Rep 2017; 2017:rjx224. [PMID: 29230284 PMCID: PMC5692993 DOI: 10.1093/jscr/rjx224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 10/26/2017] [Indexed: 11/12/2022] Open
Abstract
Amyand's hernia (AH) is characterized by the presence of the vermiform appendix in an inguinal hernia sac. Typically presenting on the right side and with manifestations similar to those seen in complicated hernias, it presents a diagnostic challenge and is frequently only diagnosed intraoperatively. We present the case of a left-sided AH on a 75-year-old man treated with appendicectomy, orchidectomy and hernioplasty without mesh.
Collapse
Affiliation(s)
- Emmanuel Katsogridakis
- Department of Surgery, The Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Oldham, UK.,Academic Surgery Unit, Education and Research Centre, University Hospital of South Manchester, Manchester, UK
| | - Goran Pokusevski
- Department of Surgery, The Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Oldham, UK
| | - Peter Byrne
- Department of Surgery, The Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Oldham, UK
| |
Collapse
|
5
|
An Appendiceal Carcinoid Tumor within an Amyand's Hernia Mimicking an Incarcerated Inguinal Hernia. Case Rep Surg 2017; 2017:5932657. [PMID: 28421155 PMCID: PMC5380831 DOI: 10.1155/2017/5932657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/16/2017] [Indexed: 11/28/2022] Open
Abstract
Introduction. We report the case of an appendiceal carcinoid tumor within an Amyand's hernia, presenting as an incarcerated right inguinal hernia. Presentation of Case. A 52-year-old male presented in the emergency department due to a persistent right inguinal pain. Clinical examination revealed a tender right groin mass. Laboratory tests revealed leukocytosis and an increased serum CRP. Under the diagnosis of an incarcerated right inguinal hernia, an emergency operation was taken. Intraoperatively, an inflamed appendix and a part of the cecum were found in the hernia sac. The operation was completed with an appendectomy and a modified Bassini hernia repair. Histological examination revealed a carcinoid tumor, resulting in the performance of a right hemicolectomy. Discussion. Amyand's hernia is estimated to account for 0.4% to 0.6% of all inguinal hernias. Coexistence of an Amyand's hernia and a neoplasia is quite rare. Carcinoids are the most frequent tumors found in the appendix, with the size of the primary tumor to be considered the most important prognostic factor and the basis upon which the operative plan is decided. Conclusion. A malignancy of the appendix should always be in the differential diagnosis of a right inguinal mass, in order to provide optimum surgical treatment.
Collapse
|
6
|
Fascetti-Leon F, Sherwood W. Neonatal Appendicitis and Incarcerated Inguinal Hernia: Case Report and Review of the Literature. J Indian Assoc Pediatr Surg 2017; 22:248-250. [PMID: 28974880 PMCID: PMC5615902 DOI: 10.4103/jiaps.jiaps_226_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Neonatal appendicitis carries a high mortality rate. We describe a peculiar case presented after an incarcerated hernia manually reduced in a 4-week-old male neonate with ipsilateral undescended testis. Laparoscopy allowed a prompt recognition of an unexpected intra-abdominal life-threatening condition. Pathogenesis, treatment, and outcome are discussed on the light of a comprehensive literature review.
Collapse
Affiliation(s)
- Francesco Fascetti-Leon
- Paediatric Surgery Department, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.,Women's and Children's Health Department, Pediatric Surgery Unit, University of Padovam, Padovam, Italy
| | - William Sherwood
- Paediatric Surgery Department, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| |
Collapse
|
7
|
Amyand's Hernia with Appendicitis: A Case Report and Integrative Review. Case Rep Surg 2015; 2015:941039. [PMID: 26640737 PMCID: PMC4657097 DOI: 10.1155/2015/941039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 09/10/2015] [Indexed: 11/18/2022] Open
Abstract
Introduction. Inguinal hernia is a common disorder with an estimated prevalence of 1.2% of the entire population and it is 12 times more common in males. Objective. To describe a case of appendix with signs of inflammation in the hernia sac, condition that is rare and difficult to diagnose, and to perform literature review, describing the most relevant aspects and the main controversies. Method. Report of a case and search in PubMed on June 1, 2015, using the terms “Appendix” [MeSH term] AND “hernia, inguinal” [MeSH term]. Results. The search resulted in 38 articles in total, and after deleting the articles that were not part of the inclusion criteria, there were 26 case reports remaining. Discussion. The search resulted in a total of 38 articles and after deleting the articles that were not part of the inclusion criteria, there were 26 case reports remaining. Conclusion. Amyand's hernia is a rare and difficult to diagnose condition, being commonly found occasionally in surgical procedures. It should be remembered in the presence of cases of incarcerated hernia, due to its possible complications if not diagnosed.
Collapse
|
8
|
Abstract
BACKGROUND Amyand's hernia with acute appendicitis is rare in infants and is mostly delayed in diagnosis and treatment, resulting in a high morbidity. METHODS We presented two cases of infantile Amyand's hernia with acute appendicitis. RESULTS Early surgical interventions were performed and both patients recovered without complication. CONCLUSION A practical strategy for this entity is to be aware of the rare disease and to perform early surgical exploration for suspected cases.
Collapse
|
9
|
Al Maksoud AM, Ahmed AS. Left Amyand's hernia: An unexpected finding during inguinal hernia surgery. Int J Surg Case Rep 2015; 14:7-9. [PMID: 26196311 PMCID: PMC4573214 DOI: 10.1016/j.ijscr.2015.06.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 06/22/2015] [Accepted: 06/27/2015] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Amyand's hernia is a rare finding of the appendix inside an inguinal hernia sac with classically estimated incidence of 1%. Most cases are found intra-operatively during right-sided inguinal hernia repair. PRESENTATION OF CASE We are reporting a very rare case of left-sided Amyand's hernia. An 81 year-old man with long standing left inguinal hernia was referred to our surgical assessment unit with tender irreducible left inguinal hernia. He was vitally stable with no clinical signs of intestinal obstruction. A diagnosis of irreducible left inguinal hernia without obstruction was made. Exploration of the hernia sac revealed the presence of non-inflamed appendix, caecum and terminal ileum. The contents were reduced and a mesh repair was performed with satisfactorily outcome. DISCUSSION The surgical management of Amyand's hernia involves appendectomy of inflamed appendix through the inguinal incision together with hernia repair. Prophylactic appendectomy is not recommended by most authors except in young patients. CONCLUSION There are less than 20 cases reported in the literature describing left-sided Amyand's hernia. Awareness of such very unusual condition may help surgeons to be prepared for appropriate management of a very usual procedure as inguinal hernia repair.
Collapse
|
10
|
Panagidis A, Sinopidis X, Zachos K, Alexopoulos V, Vareli A, Varvarigou A, Georgiou G. Neonatal perforated Amyand's hernia presenting as an enterocutaneous scrotal fistula. Asian J Surg 2015; 38:177-9. [PMID: 24751296 DOI: 10.1016/j.asjsur.2014.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Revised: 02/27/2014] [Accepted: 03/06/2014] [Indexed: 10/25/2022] Open
|
11
|
Karanikas I, Ioannidis A, Siaperas P, Efstathiou G, Drikos I, Economou N. Incarcerated Amyand hernia with simultaneous rupture of an adenocarcinoma in an inguinal hernia sac: a case report. J Med Case Rep 2015; 9:120. [PMID: 26018608 PMCID: PMC4470008 DOI: 10.1186/s13256-015-0592-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 04/08/2015] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION An Amyand's hernia is a rare occurrence of an inguinal hernia, with an estimated prevalence of 1%. The major complications of an Amyand's hernia include necrotizing fasciitis of the anterior abdominal wall and secondary intestinal perforation. Though the incidence of this type of hernia is low, the appendix may easily become initially incarcerated, possibly leading to strangulation and perforation. CASE PRESENTATION A 92-year-old female patient presented to our emergency department with clinical signs of an incarcerated right inguinal hernia, accompanied by fever. A clinical examination revealed localized abdominal pain, reflecting to the right side of her groin. Laboratory tests showed leukocytosis (13,200/μL), while an abdominal X-ray showed colon distension with evidence of intestinal obstruction. Ultrasonography was performed and confirmed the presence of an inflamed tubular structure inside her right inguinal canal. Our patient underwent emergency surgery. We started with a right inguinal incision, which revealed an incarcerated right inguinal hernia, containing her ruptured appendix and showing macroscopic evidence of malignancy. A specimen biopsy was immediately performed and the results showed a ruptured cecal adenocarcinoma. The incision was slightly extended upwards, and a right hemicolectomy performed. CONCLUSIONS Diagnosis of an Amyand's hernia occurs primarily as an incidental finding during surgery and the optimal therapeutic approach must be considered individually for each case. Owing to the rarity of Amyand's hernia and the wide variance of its clinical characteristics, every case provides useful information toward the treatment of this type of hernia.
Collapse
Affiliation(s)
- Ioannis Karanikas
- Department of Surgery, Sismanoglion General Hospital, Sismanoglou 1, P.O. BOX 15126, Athens, Greece.
| | - Argyrios Ioannidis
- Department of Surgery, Sismanoglion General Hospital, Sismanoglou 1, P.O. BOX 15126, Athens, Greece.
| | - Petros Siaperas
- Department of Surgery, Sismanoglion General Hospital, Sismanoglou 1, P.O. BOX 15126, Athens, Greece.
| | - Georgios Efstathiou
- Department of Surgery, Sismanoglion General Hospital, Sismanoglou 1, P.O. BOX 15126, Athens, Greece.
| | - Ioannis Drikos
- Department of Surgery, Sismanoglion General Hospital, Sismanoglou 1, P.O. BOX 15126, Athens, Greece.
| | - Nicolaos Economou
- Department of Surgery, Sismanoglion General Hospital, Sismanoglou 1, P.O. BOX 15126, Athens, Greece.
| |
Collapse
|
12
|
Al-Mayoof AF, Al-Ani BH. Left-sided amyand hernia: report of two cases with review of literature. European J Pediatr Surg Rep 2015; 2:63-6. [PMID: 25755974 PMCID: PMC4336050 DOI: 10.1055/s-0033-1347131] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 04/16/2013] [Indexed: 11/13/2022] Open
Abstract
The presence of the vermiform appendix in an inguinal hernial sac is called “Amyand” Hernia, which is a rare condition especially in children. The authors are reporting two cases of left-sided Amyand hernia in infants presented with symptoms and signs of obstructed inguinal hernia. Emergency appendectomy and herniotomy were performed. The patients were followed up for 4 to 6 months without complications. The case histories are presented, and the conditions discussed with review of the literature.
Collapse
Affiliation(s)
- Ali Farooq Al-Mayoof
- Department of Paediatric Surgery, Al-Mustansyriah Medical College/Central Teaching Hospital of Pediatrics, Baghdad, Iraq
| | - Bilal Hamid Al-Ani
- Department of Paediatric Surgery, Al-Mustansyriah Medical College/Central Teaching Hospital of Pediatrics, Baghdad, Iraq
| |
Collapse
|
13
|
Michalinos A, Moris D, Vernadakis S. Amyand's hernia: a case series with critics of role of appendectomy. Hernia 2014; 19:987-90. [PMID: 24384719 DOI: 10.1007/s10029-013-1209-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 12/21/2013] [Indexed: 12/01/2022]
Abstract
Amyand's hernia is an inguinal hernia that contains vermiform appendix in its sac. It consists 1% of all inguinal hernias while appendicitis in an Amyand's hernia accounts for 0.1% of all appendicitis cases. Its clinical image is identical to that of an incarcerated or perforated inguinal hernia. Diagnosis is usually established intraoperatively. Hernioplasty (with or without mesh repair and with or without appendectomy) is the treatment of choice. According to Losannof and Basson's criteria, performance of appendectomy shall depend on vermiform appendix's inflammation status. In this case series, authors present three patients who had to undergo prophylactic appendectomy because of medical conditions, unrelated to appendix's inflammation status thus escaping from therapeutic frame set by Losanoff and Basson's criteria.
Collapse
Affiliation(s)
- A Michalinos
- 1st Department of Surgery, Athens University School of Medicine, "Laikon" University Hospital, 2nd Floor, Agiou Thoma 17 Str., Goudi, 15771, Athens, Greece. .,Department of General and Transplantation Surgery, "Laikon" General University, Athens, Greece.
| | - D Moris
- 1st Department of Surgery, Athens University School of Medicine, "Laikon" University Hospital, 2nd Floor, Agiou Thoma 17 Str., Goudi, 15771, Athens, Greece.,Department of General and Transplantation Surgery, "Laikon" General University, Athens, Greece
| | - S Vernadakis
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany.,Department of General and Transplantation Surgery, "Laikon" General University, Athens, Greece
| |
Collapse
|
14
|
Michalinos A, Moris D, Vernadakis S. Amyand's hernia: a review. Am J Surg 2013; 207:989-95. [PMID: 24280148 DOI: 10.1016/j.amjsurg.2013.07.043] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 06/20/2013] [Accepted: 07/02/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND The presence of a vermiform appendix in an inguinal hernia sac is known as Amyand's hernia. The aim of this systematic review was to gather information concerning its prevalence, clinical image, diagnosis, and treatment. DATA SOURCES The MEDLINE database was thoroughly searched using the keyword "Amyand's hernia." Additional articles were gathered and evaluated. CONCLUSIONS The true prevalence of Amyand's hernia seems lower than classically described. Its usual clinical image is identical to that of an incarcerated hernia, and thus it is almost impossible to diagnose preoperatively, although ultrasound and computed tomography can help. Treatment includes hernioplasty with or without appendectomy and/or mesh repair depending on the vermiform appendix's inflammation status, the patient's general condition, and other factors. Amyand's hernia generally has a good prognosis, although serious complications have been described. Surgeons should be prepared if they encounter Amyand's hernia because appropriate treatment ensures hernia repair without complications and with avoidance of recurrence.
Collapse
Affiliation(s)
- Adamantios Michalinos
- 1st Department of Surgery, Athens University School of Medicine, "Laikon" University Hospital, 2nd Floor, Agiou Thoma 17 Str, Goudi, Athens, Greece; Department of General and Transplantation Surgery, "Laikon" General University, Athens, Greece.
| | - Demetrios Moris
- 1st Department of Surgery, Athens University School of Medicine, "Laikon" University Hospital, 2nd Floor, Agiou Thoma 17 Str, Goudi, Athens, Greece; Department of General and Transplantation Surgery, "Laikon" General University, Athens, Greece
| | - Spiridon Vernadakis
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany; Department of General and Transplantation Surgery, "Laikon" General University, Athens, Greece
| |
Collapse
|
15
|
Li B, Zhang JY, Wang YB, Chen WB, Wang SQ, Jin LG, Li DH. Laparoscope-assisted diagnosis and treatment for Amyand's hernia in children-report of six cases. Pediatr Surg Int 2013; 29:525-8. [PMID: 23292541 DOI: 10.1007/s00383-012-3256-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/18/2012] [Indexed: 10/27/2022]
Abstract
Laparoscope-assisted diagnosis and treatment of Amyand's hernia in children are rarely reported in literature. We report our preliminary experiences to emphasize the advantages and feasibility of this procedure in six cases. Laparoscope-assisted diagnosis and treatment of Amyand's hernias in six children from October 2010 to February 2012 were performed. A retrospective analysis of clinical data of these patients was performed. The mean age of the six patients was 234 days (ranging from 40 days to 13 months). Four cases were operated with laparoscope-assisted method urgently as incarcerated hernia. To the two cases with normal appendix, only herniorrhaphy was performed. Average follow-up was 14 months (9-24 months), with no wound infection and no recurrent hernias. In conclusion, diagnosis of Amyand's hernia before operation is difficult, and laparoscopic method is safe and effective in these cases with good outcomes, and worth introduced.
Collapse
Affiliation(s)
- Bing Li
- Department of Pediatric Surgery, Huai An Women and Children's Hospital, Huai'an, 223002 Jiang Su, China.
| | | | | | | | | | | | | |
Collapse
|