Published June 19, 2020 | Version v1
Journal article Open

A rare case of Amyand's hernia with acute appendicitis in a 69-year-old woman: a case report

  • 1. Department of Radiology, University Clinic of Surgery "St. Naum Ohridski" bul. 11 Oktomvri br. 53, 1000, Skopje, North Macedonia

Description

Introduction: Amyand’s hernia is an extremely rare and atypical hernia that is difficult to diagnose clinically characterized by the herniation of the appendix into the inguinal sac. The aim of this report is to describe a case of Amyand’s hernia and highlights the importance of early CT scanning in reaching the exact and early diagnosis of Amyand’s hernia.
Case report: We present a rare case of a 69-year-old female patient with a history of intermittent pain in the right inguinal region is see at the emergency surgical clinic. The patient underwent a CT scan of the abdomen and a small pelvis, and an inflamed appendix was diagnosed. The inflamed appendix is herniated in the inguinal hernia sac. Computed tomography was the only modality to diagnose the hernia sac contents preoperatively.
Discussion: The reported incidence of Amyand’s hernia is less than 1% of all adult inguinal hernia cases. Acute appendicitis in Amyand’s hernia is even less common, with 0,1% of all cases of acute appendicitis. This hernia may be present without symptoms until the inflammation of the appendix may lead to incarceration, strangulation, necrosis, perforation, or rupture. Early symptoms include tenderness and inguinal swelling.
Conclusions: Computer tomography helps make an accurate and timely diagnosis of Amyand’s hernia, thus avoiding complications from delayed surgery.

Files

A rare case of Amyand’s hernia with acute appendicitis _Gligorievski.pdf

Additional details

References

  • McIntosh A, Hutchinson A, Roberts A, Withers H. Evidence-based management of groin hernia in primary care--a systematic review. Fam Pract. 2000;17(5):442-7. doi: 10.1093/fampra/17.5.442.
  • Ivanschuk G, Cesmebasi A, Sorenson EP, Blaak C, Loukas M, Tubbs SR. Amyand's hernia: a review. Med Sci Monit. 2014;20:140-6. doi: 10.12659/MSM.889873.
  • Lyass S, Kim A, Bauer J. Perforated appendicitis withen an inguinal hernia; a case report and review of literature. Am J Gastroenterol. 1997;92(4):700-2.
  • D'Alia C, Lo Schiavo MG, Tonante A, Taranto F, Gagliano E, Bonanno L, et al. Amyand's hernia: case report and review of the literature. Hernia. 2003;7(2):89-91. doi: 10.1007/s10029-002-0098-5.
  • Maizlin ZV, Mason AC, Brown C, Brown JA. CT findings of normal and inflamed appendix in groin hernia. Emerg Radiol. 2007;14(2):97-100. doi: 10.1007/s10140-007-0601-5.
  • Anagnostopoulou S, Dimitroulis D, Troupis T, Allamani M, Paraschos A, Mazarakis A, et al. Amyand's hernia: a case report. World J Gastroenterol. 2006;12(29):4761-3. doi: 10.3748/wjg.v12.i29.4761.
  • To J, Hanna P, Mohammed R, Trinh S, Vazquez F, Zuberi J, et al. Amyand's hernia presenting as an unusual inguinal mass: a case report. Ann Transl Med. 2017;5(17):346. doi: 10.21037/atm.2017.06.59.
  • Mebis W, Hoste P, Jager T. Amyand's Hernia. J Belg Soc Radiol. 2018;102(1):8. doi: 10.5334/jbr-btr.1402.
  • Fernando J, Leelaratna S. Amyand's hernia. Ceylon Med J. 2002;47(2):71.
  • Sharma H, Gupta A, Shekhawat NS, Memon B, Memon MA. Amyand's hernia: a report of 18 consecutive patients over a 15-year period. Hernia. 2007;11(1):31-5. doi: 10.1007/s10029-006-0153-8.
  • Tsang WK, Lee KL, Tam KF, Lee SF. Acute appendicitis complicating Amyand's hernia: imaging features and literature review. Hong Kong Med J. 2014;20(3):255-7. doi: 10.12809/hkmj133971.
  • Amyand C. Of an inguinal rupture, with a pin in the appendix coeci incrusted with stone; and some observations on wounds in the guts. Philos T R Soc (London). 1736;39:329-42. doi: https://doi.org/10.1098/rstl.1735.0071.
  • Michalinos A, Moris D, Vernadakis S. Amyand's hernia: a review. Am J Surg. 2014;207(6):989-95. doi: 10.1016/j.amjsurg.2013.07.043 14.
  • Esteban-Zubero E, Andrés-Matías M, Alatorre-Jiménez MA, Marín-Medina A, Morros-Blanco L, Soto Brambila A, et al. Amyand's Her-nia, an Unusual Inguinal Hernia. A Case Report. Mathews J Case Rep. 2018;3(2):041.
  • Patoulias D, Kalogirou M, Patoulias I. Amyand's Hernia: an Up-to-Date Review of the Literature. Acta Medica (Hradec Kralove). 2017;60(3):131-4. doi: 10.14712/18059694.2018.7.
  • Logan MT, Nottingham JM. Amyand's hernia: a case report of an incarcerated and perforated appendix within an inguinal hernia and review of the literature. Am Surg. 2001;67(7):628-9.
  • Sadhu J, Samuel VM, Kodiatte T, Gaikwad P. Amyand's Hernia: Case Report -Current Dilemma in Diagnosis and Management. J Clin Diagn Res. 2015;9(2):PD03-PD4. doi: 10.7860/JCDR/2015/11295.5548.
  • Shekhani HN, Rohatgi S, Hanna T, Johnson JO. Amyand's Hernia: A Case Report. J Radiol Case Rep. 2016;10(12):7-11. doi: 10.3941/jrcr.v10i12.2833.
  • Losanoff JE, Basson MD. Amyand hernia: what lies beneath--a proposed classification scheme to determine management. Am Surg. 2007;73(12):1288-90.