Intraoperative finding of Amyand’s hernia in a recurrent inguinal hernia Report of a case

Abstract

INTRODUCTION: The finding of the vermiform appendix within an inguinal hernia is a rare entity 2,3. An inflamed or non-inflamed vermiform appendix in an inguinal hernia sac is named Amyand’s hernia in honor to the surgeon Claudius Amyand who published the first case of perforated appendicitis within inguinal hernia in a boy caused by ingested pin. 

OBJECTIVE: The aim of this study was to report our intraoperative findings with this entity. 

MATERIAL AND METHODS: We report a case of 47 year old male patient with a recurrent right inguinal hernia. We were not able to review the previous operative notes . The patient underwent an elective redo-redo inguinal hernia repair under local anesthesia with I.V. sedation; a normal appearing appendix with an adhesive plug were explored within a direct hernia sac. Adhesions were divided by sharp dissection, an appendectomy was performed and the plug excised. A modified Bassini repair was performed and the patient admitted to the hospital. 

RESULTS: The patient’s postoperative course was unremarkable; he was discharged home on postoperative day 3. At one week follow-up we found no complications. 

CONCLUSION: The finding of the appendix in an inguinal hernia is a rare entity that is difficult to diagnose preoperatively. Treatment includes appendectomy and herniorraphy. The use of prosthetic mesh depends on the status of the appendinx, patient’s condition and hernia findings.