AMYAND'S HERNIA – A CONTINUUM OF CLINICAL PRESENTATION AND LITERATURE REVIEW

Abstract

Introduction: Amyand's hernia is dened as an inguinal hernia containing a vermiform appendix within its sac. The incidence of this rare entity ranges from 0.9% to 1.7%. It poses a diagnostic challenge due to its low incidence, indistinct clinical presentation, and ambiguous appearance on imaging. Therefore, surgery is often performed for diagnosis as well as for treatment. Here we report different presentations of Amyand's hernia as case scenarios. A 67-year-old male and a 65-year-old-male presented to the emergency room with an irreducible rightCase Presentations: inguinal hernia and subacute small bowel obstruction. A 77-old-male was electively admitted for right inguinal hernia repair. Normal Appendix was encountered in all three patients when the hernial sac was explored. Hence, they were treated with inguinal hernia repair alone while preserving the appendix. The rst patient had an appendix, cecum, and part of ascending colon in a viable state with some infected peritoneal uid in the hernial sac and was treated with Desarda's hernia repair without mesh. The second patient had appendix, cecum, distal ileum, and part of ascending colon in the hernial sac with no evidence of infection and the third patient had only an appendix in a healthy state in the hernial sac. Both patients were treated with Amid's modication of Lichtenstein's tension-free hernioplasty with polypropylene mesh. All patients had uneventful postoperative period and follow-up visits. Surgeons worldwide agree with the fact that, since the appendix may be non-inamedConclusion: when found within the inguinal hernia sac, removal is not always compulsory. By the rarity, and the wide divergence of its presentation, each case series and review article bring valuable information regarding its diagnosis and treatment.