Amyand Hernia: What Lies Beneath–A Proposed Classification Scheme to Determine Management

Author:

Losanoff Julian E.1,Basson Marc D.2

Affiliation:

1. Surgical Service, John D. Dingell VAMC, Detroit, Michigan;

2. Department of Surgery, Wayne State University, Detroit, Michigan

Abstract

Acute appendicitis in a hernia sac occurs exceptionally. An 80-year-old male patient underwent emergency surgery for an incarcerated right inguinal hernia found to contain a gangrenous appendix. His brief improvement after an emergency herniotomy with appendectomy was followed by intestinal obstruction caused by advanced colon cancer. The unique features and individualized management of the four published types of Amyand hernia are reviewed. Rather than simply being an anatomical curiosity, Amyand hernias require individualized attention to decide how to manage both the appendix and the hernia. Clinical scrutiny, a high index of suspicion for surgical comorbidities, and a common sense approach may improve outcomes.

Publisher

SAGE Publications

Subject

General Medicine

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