Incarcerated Amyand’s hernia. Personal experience and literature review

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COD: 2379_04_05_2015_ep Categorie: ,

Paolo Caiazzo, Pierpaolo Di Lascio, Alessandro Crocoli, Antonio Zaccara, Maria Esposito, Massimo Rivosecchi

Ann. Ital. Chir.Published online (EP) 4 May 2015

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The finding of vermiform appendix in an inguinal hernia is called Amyand’s hernia. Two cases of a 30 days and 4months old children respectively are presented; they had been visited a month earlier and scheduled for inguinal hernioto-my in elective surgery.On admission both the patients presented a non-reducible mass in the right inguinal region. Surgical exploration wasperformed under general anaesthesia. Inguinal canal is opened through transverse lower abdominal skin incision. We pal-pated a tubular swelling, of tense-elastic consistence through swollen cremaster muscle and hernial sac. Separating cre-master muscle, we opened swollen hernia sac and we found the vermiform appendix, not inflamed. We easily reducedthe appendix into the peritoneum cavity, and then we performed the herniotomy according to the Mugnai-Ferrari tech-nique. No post-operative morbidity was reported. The patients was discharged in the first postoperative. We did not haveany doubt about avoiding appendectomy in both cases presented; in fact such an intervention, especially in so youngpatients, had no pathophysiological justification, while it increases the postoperative mortality rate.