Amyand's hernia a case report

Amyand's hernia: a case report

An Amyand's hernia is a type of inguinal hernia where the appendix protrudes into the hernial sac. Pre-operative diagnosis is clinically challenging and ultimately the diagnosis is made intra-operatively. We report on a 75-year-old lady who presented with abdominal pain and a lump in her right groin region. She proceeded to theatre and had a diagnostic laparoscopy where she was diagnosed with an Amyand's hernia. The appendix was mildly inflamed and there was an ischemic appearance of the mesoappendix. According to the guidelines proposed by Losanoff and Basson she subsequently underwent a successful laparoscopic appendicectomy and primary repair of the hernia.

Amyand's hernia with appendicitis in a 64-year-old male: a case report

We present a medical case of a 64-year-old male patient who exhibited symptoms of a hernia in the right inguinoscrotal region, which could not be reduced, and was accompanied by a systemic inflammatory response, ultimately revealing a perforated appendicitis during surgery as the hernia's contents. The relatively rare occurrence and lower probability of an Amyand's hernia may prompt a question about the most effective surgical treatment for our patient. The main aim of this study is to expand the current body of research on this condition, which should allow for a more thorough understanding of it.

Management of Perforated Appendicitis in Amyand's Hernia: A Multidisciplinary Approach to Complex Postoperative Complications

Amyand's hernia is an exceptionally rare condition in which the appendix is located within an inguinal hernia sac. While it is typically asymptomatic, the occurrence of appendicitis or perforation within these hernias presents significant diagnostic and therapeutic challenges. We report a unique case involving a 31-year-old male patient who developed perforated appendicitis within an Amyand's hernia, resulting in severe intra-abdominal infection and complex postoperative complications, including the formation of multiple abscesses at three different sites. A multidisciplinary approach, involving general surgery, infectious disease, interventional radiology (IR), and urology, was crucial for effective source control and infection management. This case underscores the importance of individualized surgical decision-making in cases of Amyand's hernia with significant inflammatory involvement, emphasizing the necessity for timely recognition and intervention to minimize complications and improve patient outcomes.

Management of a Patient With an Obstructed Inguinal Hernia With Amyand's Variety: A Report of a Rare Case With a Review of the Literature

Amyand's hernia is a rare form of inguinal hernia, where the appendix is located within the inguinal sac. A 66-year-old male presented with an obstructed, incarcerated right inguinal hernia. He underwent an emergency herniotomy under spinal anesthesia. Intraoperatively, the hernia sac contained a viable small bowel and part of the appendix. As the appendix appeared mildly inflamed, an appendicectomy was performed, and a synthetic mesh repair was done. He received a postoperative course of antibiotics and was discharged home on day 3 after an uneventful recovery. Histology of the appendix revealed a fecolith in the absence of acute inflammation. He did not have any procedure-related complications on follow-up. Preoperative diagnosis of Amyand's hernia is a challenge due to nonspecific symptoms and rarity. Lasanoff and Basson classify Amyand's hernia and provide surgical guidance for its management. Our case belonged to the type 2 category. Management of Amyand's hernia needs an individually tailored approach rather than strict adherence to conventional guidelines. The presence of an appendicular fecolith in the absence of inflammation provides an interesting area to explore in an Amyand's hernia.

A Case of Amyand's Hernia

Inguinal hernias are the most prevalent type of abdominal wall hernia. While many cases are uncomplicated, some variant forms can pose a heightened risk of severe complications. We report the case of a 46-year-old male who arrived at the emergency department with a two-day history of diffuse abdominal pain, with an otherwise negative review of systems, an unremarkable medical and surgical history, and normal laboratory results. The physical examination revealed a palpable, non-reducible mass in the right groin, raising suspicion of an inguinal hernia. A CT scan of the abdomen and pelvis was conducted, confirming Amyand's hernia, characterized by the presence of the vermiform appendix within the hernia sac in the dilated right inguinal canal. Amyand's hernia is a rare and clinically challenging condition to diagnose because its symptoms are nonspecific and often resemble those of other inguinal hernias. Delayed diagnosis can heighten the risk of complications, including inflammation, infection, perforation, and acute appendicitis. Mortality rates for Amyand's hernias have been reported to be between 14% and 30%, primarily due to complications associated with infections, especially peritoneal sepsis. Prompt diagnosis and treatment of Amyand's hernia, usually involving surgical hernia repair and an appendectomy if appendicitis is present, are highly effective in preventing potentially life-threatening complications. Despite their rarity, the difficult nature of the diagnosis and the associated high mortality rate underscore the importance of considering Amyand's hernia as a serious differential diagnosis.

Unilateral Concurrent Amyand's Hernia and Inguinal Bladder Hernia (IBH): A Case Report

An inguinal hernia is a common surgical condition where abdominal contents protrude through a weakened area of the abdominal wall. While most are straightforward, rare variants can lead to significant complications. Named after the surgeon who successfully removed a vermiform appendix from a hernia sac, Amyand's hernia is a rare finding. Similarly, an inguinal bladder hernia (IBH) is a rare condition where part of the urinary bladder protrudes into the inguinal canal. We present a unique case of a 62-year-old male who presented to the emergency department with a one-day history of lower abdominal pain, exacerbated by physical exertion. The absence of associated symptoms like nausea, vomiting, fever, or urinary symptoms made his condition challenging to diagnose clinically. However, computed tomography (CT) scans of the abdomen and pelvis confirmed the diagnosis of concurrent Amyand's hernia and IBH. The definitive treatment for symptomatic and painful inguinal hernias involves surgery, either open or laparoscopic hernia repair, while asymptomatic, lower-risk inguinal hernias may be observed before intervention is warranted. This report underscores the challenge of balancing the benefits of standardizing diagnostic protocols, particularly preoperative diagnosis and management guidelines for rare variants of inguinal hernias, with the associated costs. In this case, the absence of typical urinary symptoms commonly seen in IBH further complicated the diagnostic process, exemplifying the challenge of identifying such rare anomalies. While standardized screening could help prevent serious and potentially fatal complications, it also poses a strain on medical resources and may lead to unnecessary emotional and physical stress for patients when screening for rare variants of inguinal hernias.

Amyand's hernia: a case of right inguinoscrotal hernia with appendiceal content

Introduction

Amyand's hernia, a rare condition where the appendix becomes lodged in the inguinal canal, poses diagnostic challenges due to its varied clinical presentations and lack of distinctive radiological features. This case underscores the importance of early detection and comprehensive diagnostic evaluation.

Case Presentation

A 30-year-old male presented with a 2-year history of right inguinoscrotal swelling, culminating in agonizing symptoms and irreducible masses over the inguinoscrotal area. Despite the absence of significant medical history, diagnostic imaging confirmed a complete right inguinoscrotal hernia and bilateral hydrocele with internal echoes.

Clinical Discussion

The case illustrates the difficulties in preoperative diagnosis of Amyand's hernia, emphasizing the reliance on imaging modalities and clinical assessment. Successful surgical intervention involving appendectomy and hernioplasty highlights the necessity for prompt diagnosis and management.

Conclusion

This case exemplifies the challenges and complexities associated with Amyand's hernia, emphasizing the importance of early recognition and comprehensive surgical planning. Moving forward, increased clinical vigilance and awareness are essential to ensure optimal patient outcomes in cases of inguinoscrotal pathology.

Two cases of intraoperative diagnosed Amyand hernia: Case report and literature review

INTRODUCTION

Amyand hernia is the presence of an incarcerated vermiform appendix (either inflamed or not) within the hernia sac. This type of hernia is very rare with an incidence reported to be 0.5 to 1 % and even rarer in adults.

CASES PRESENTATION

We present here two cases of male patients found the have an Amyand Hernia diagnosed incidentally intraoperatively, and managed with appendectomy and mesh herniorrhaphy.

CLINICAL DISCUSSION

For the management of this type of hernia, in general, the surgeon should perform an appendectomy with the repair to prevent future herniation or appendicitis, but some opinions differ, and state that when there are no signs of inflammation, it is not required to perform a preventative appendectomy.

CONCLUSION

The decision on how to manage depends on multiple factors including inflammation of the appendix, the possibility of abdominal sepsis, and the patient comorbidities. The status of the appendix determines whether to undergo hernia repair with or without mesh.

Controversies Regarding Mesh Utilisation and the Attitude towards the Appendix in Amyand's Hernia-A Systematic Review

Inguinal hernia containing the vermiform appendix is a rare entity. It is more common in children than in adults. It can be discovered incidentally during the surgical intervention performed for the cure of the inguinal hernia or when the appendix shows inflammatory changes, a situation that can lead to diagnostic confusion with a number of other diseases. Imaging can guide the diagnosis, which often comes as an intraoperative surprise. The therapeutic approach is controversial both in terms of whether or not to perform an appendectomy in the case of an appendix without inflammatory changes and especially in terms of using a mesh during the hernia repair process. Since the pathology is not very frequent, there are no standardized stages in terms of surgical ethics that can guarantee good surgical practice. The study aimed to carry out a review of the specialized literature to obtain some conclusions or trends regarding the management of this pathology. The low frequency of this type of hernia did not allow the consultation of large-scale studies or extensive reviews focusing on case reports or case series communications. The obtained results were statistically analyzed and integrated in relation to the surgical attitude depending on the particularities of the condition.