Amyand's hernia complicated with appendix perforation treated by two-stage surgery consisting of laparoscopic appendectomy followed by elective inguinal hernioplasty: A case report. (2018)

• Record Type: Journal Article
• Authors: Akaishi, Ryujiro; Nishimura, Ryuichi; Naoshima, Kiminari; Miyazaki, Shukichi
• Is Part Of: International journal of surgery case reports. Volume 47(2018)
• Page Start: 11
• Page End: 13
• Publication Date: 2018
• Subjects: SSI surgical site infection; Amyand's hernia -- Appendix perforation -- Laparoscopic appendectomy -- Inguinal hernioplasty -- Case report; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2018.04.019
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Amyand's hernia with appendix perforation is an extremely rare condition. Very few cases of Amyand's hernia with appendix perforation used laparoscope as a therapeutic tool. Laparoscopic approach is diagnostic and enables two stage operation to the perforated cases. Abstract: Introduction: An inguinal hernia with an incarcerated appendix is defined as Amyand's hernia, and it is relatively rare. Amyand's hernia complicated with appendicitis, especially perforated appendicitis, is even rarer. Postoperative surgical site infection (SSI) is a dangerous complication, especially in Amyand's hernia with appendix perforation. The selection of an appropriate surgical approach is necessary to prevent postoperative SSI. Here, we report a case of Amyand's hernia complicated with appendix perforation that was successfully managed using a two-stage surgical approach consisting of laparoscopic appendectomy followed by elective inguinal hernioplasty. Presentation of case: A 70-year-old male presented with fever and right lower quadrant pain from the day before. After the patient was diagnosed with acute appendicitis within a right inguinal hernia, emergency laparoscopy was performed. The appendix was incarcerated in the right internal inguinal ring and perforated at the base. We decided to take a two-stage surgical approach to avoid postoperative SSI and performed only laparoscopic appendectomy. No postoperative complications occurred. Inguinal hernioplasty was performed 1 month after the first operation. There were no adhesions in the preperitoneal space, and no adverse events occurred postoperatively. Conclusions: A two-stage surgical approach consisting of laparoscopic appendectomy followed by elective inguinal hernioplasty was used successfully to treat Amyand's hernia complicated with appendix perforation without causing postoperative SSI.