Case Report
Volume 8 Issue 10 - 2021
Amyand’s Hernia: A Challenging Diagnosis
Aldo Manuel Rodrigues Jarimba1*, Luís Ferreira A2, Teslyak O2, Ratinho J3, Marques S3 and Barradas R35
1Resident of General Surgery, Hospital Distrital de Santarém, Santarém, Portugal
2Colonic and Rectal Surgeon and General Surgeon, Hospital Distrital de Santarém, Santarém, Portugal
3Resident of General Surgery, Hospital Distrital de Santarém, Santarém, Portugal
*Corresponding Author: Aldo Manuel Rodrigues Jarimba, Resident of General Surgery,Hospital distrital de Santarém, Santarém, Portugal.
Received: August 18, 2021; Published: September 24, 2021




Abstract

Background: Hernia repair surgery is a procedure frequently performed today, both in elective or outpatient settings as in an emergency context. Hernia is defined as a condition in which part of an organ or its fascia protruded through the wall of the cavity containing it. Quite often in the emergency department incarcerated hernias are found, and in most cases, the content of the hernia sac is the omentum or small intestine. In very rare instances, the appendix can be found inside the hernia sac. When the appendix is found in the hernia sac it is called an "Amyand Hernia", regardless if it is inflamed or not, with the incidence of appendicitis in an inguinal hernia being 0.07 - 0.13%. Preoperative diagnosis of an Amyand hernia is a clinical and often a Radiological challenge, being in many cases misdiagnosed as an incarcerated inguinal hernia. Usually, the diagnosis of Amyand's hernia is an incidental finding during surgical repair of an inguinal hernia. There is still no real consensus on the ideal surgical treatment approach for this pathology.

Clinical Case: A 72-year-old man, with a known reducible right inguinal hernia awaiting surgical repair presented to the Emergency Department with acute abdominal pain, nausea, vomiting and a painful right groin mass. He was diagnosed with an incarcerated right inguinal hernia and taken to the operating room for emergency surgery. An open approach was performed with a transverse right inguinal incision and the inflamed appendix was identified inside the inguinal sac. The patient was submitted to an appendectomy and subsequently, using the Bassini technique, had the incarcerated inguinal hernia corrected.

Conclusion: Preoperative clinical and imaging diagnosis of amyand´s hernia is rare and difficult. More prospective studies should be carried out in order to standardize the treatment of this pathology. The diagnosis of Amyand´s hernia should be in the surgeon's mind especially in the case of a strangulated inguinal hernia, as shown in this case.

Keywords: Acute Appendicitis; Appendectomy; Amyand Hernia; Hernia Repair

References

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Citation: Aldo Manuel Rodrigues Jarimba., et al. “Amyand’s Hernia: A Challenging Diagnosis”. EC Gastroenterology and Digestive System 8.10 (2021): 76-80.

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