Amyand's Hernia: Correct Surgical Management

Abstract

Introduction: The vermiform appendix in an inguinal hernia was described for the first time by Claudius Amyand, French military surgeon (1660-1740), regardless of the location of the appendix. Objective: To present a case. Method: A 57-year-old male presents with a 3-year right inguinal hernia with occasional intermittent fixed colic pain of mild intensity radiating to the ipsilateral testicle with a reducible mass effect and alteration in the conformation of the inguinal region. Amyand's hernia was diagnosed without any appendicular or septic inflammatory process. Laparoscopic inguinal plastic with mesh is performed. No complications. Discussion: classically Amyand's hernia occurs in 1% of all inguinal hernias, and appendicitis in Amyand’s hernia accounts for 0.1% of appendicitis cases. Inguinal hernia is a common clinical condition, affecting 27-43% of men and 3-6% of women, its clinical presentation simulates acute appendicitis. Even with proper evaluation, its identification is usually particularly difficult, even by ultrasound or CT scan. Although the surgical treatment strategy remains controversial, especially in cases of Amyand's hernia with abscess formation, it is the question/option. Conclusion: patients with Amyand's hernia are today a challenge in the matter of making decisions regarding what conduct to follow regarding their treatment. Although its incidence is low, it should not be taken lightly, since the moment in which only the expertise of the Chief Surgeon is presented, will make the difference that will directly impact morbidity/mortality.