Amyand's hernia: A case report and review of the literature. (2018)

• Record Type: Journal Article
• Authors: Shaban, Youssef; Elkbuli, Adel; McKenney, Mark; Boneva, Dessy
• Is Part Of: International journal of surgery case reports. Volume 47(2018)
• Page Start: 92
• Page End: 96
• Publication Date: 2018
• Subjects: Acute appendicitis -- Appendix in hernia -- Appendectomy -- Amyand hernia -- Hernia repair; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2018.04.034
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: It may be beneficial for patients with type 2 Amyand's hernia to have an appendectomy with a tension free hernia repair using mesh. Controversies still exist regarding the recognized classification system and treatment algorithm of Amyand hernia. Controversy exists regarding the use of mesh for the treatment of type 2 Amyand's hernia however we add to the argument of pro-mesh. Abstract: Introduction: An Amyand hernia is a rare disease where the appendix is found within an inguinal hernia sac. This rare entity is named after the French born English surgeon, Dr. Claudius Amyand. Inguinal hernias are one of the most common surgeries that a general surgeon performs with more than 20 million inguinal hernia repairs performed yearly worldwide. The incidence of finding an appendix within the hernia sac is rare, occurring in less than 1% of inguinal hernia patients and when complications arise such as inflammation, perforation, or abscess formation it becomes exceptionally rare with an incidence of about 0.1%. Presentation of case: A 59-year-old male with a history of a previously reducible right inguinal hernia presented to the Emergency Department with acute abdominal pain, right groin mass. Computed tomography (CT) confirmed a right incarcerated inguinal hernia with herniated loops of bowel within the right inguinal region. Patient was subsequently treated with an appendectomy and tension free hernia repair with mesh with a successful outcome. Discussion: The current generally accepted treatment algorithm for Amyand's hernia is essentially contingent on the appendix's condition within the hernia sac. Controversy exists regarding the application of mesh in type 2 Amyand's hernia. More research is needed to provide surgeons with evidence-based standardized approaches for dealing with this unique situation. Conclusion: This case report reviews a rare entity known as an Amyand's hernia that presented as an incarcerated hernia that was diagnosed intraoperatively with an inflamed appendix, recognized as a type 2 Amyand's hernia.