Management of Incidental Amyand Hernia With A Case Report

The presence of appendix vermiformis in inguinal hernia is known as Amyand hernia. Amyand hernia is a rare condition estimated to account for approximately 1% of all inguinal hernias. In our case we want to show our approach to incidental Amyand hernia. An 80-year-old male patient was received at urology service at Van Yuzuncu Yil University Department of Medicine because of prostatic symptoms. There were comorbid factors like hypertension,chronic obstructive lung disease and geriatric age. On surgery with spinal anesthesia, surgeons invited us to evaluate his left inguinal hernia. We evaluated hernia and saw distal ileal segments, proximal right colonic segments and inflamme appendix at hernia defect. Because of appendix inflammation we performed appendectomy. Hernia was repaired with mesh. We put a drain at surgery area. At postoperative first day, the patient discharged with drain. The fifth day of post-surgery, the drain was pulled out. At the time of 1st and 3rd month check of the patient, there was no problem about surgery. Amyand hernia is one of the rare conditions encountered by the surgeon during hernia surgery. The surgeon must know the Rosanoff and Bassoon Classification of Amyand Hernia to successfully manage Amyand hernia surgery. The surgeon also must know the situation in which case an appendectomy should be performed and in which case the mesh should be used.

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1. Hutchinson R. Amyand´s hernia. J R Soc Med 1993; 86: 104-105.

2. Shaban Y, Elkbuli A, McKenney M and Boneva D. Amyand’s hernia: A case report and review of the literature. International Journal of Surgery Case Reports 2018; 47: 92-96.

3. Öztaş M, Yıldız R, Can MF, et al. Amyand’s Hernia; Case Series and Our Ten Years Experience. Journal of Surgical Arts 2013; 6: 1-3.

4. Carey LC. Acute appendicitis occuring in hernias: a report of 10 cases. Surgery 1967; 31: 236-238.

5. Tanrıkulu Y, Erel S, Tanrıkulu CŞ, Taşova V, Ortaç EK. Olgu Sunumu: Amyand Herni. Akademik Acil Tıp Dergisi 2011: 174-176.

6. Gupta S, Sharma R, Kaushik R. Left-sided Amyand’s hernia. Singapore Med J 2005; 46: 424- 425.

7. Lao OB, Fitzgibbons RJ, Cusick RA. Pediatric surgery pediatric inguinal hernias, hydroceles,and undescended testicles. Surg Clin N Am 2012; 92: 487-504.

8. Ciğsar EB, Karadağ ÇA, Dokucu AI. Amyand's hernia: 11 years of experience. Journal of Pediatric Surgery Journal of Pediatric Surgery 51 2016; 1327-1329.

9. Solecki R, Matyja A, Milanowski W. Amyand’s hernia: a report of two cases. Hernia 2003; 7: 50- 51.

10. Ryan WJ. Hernia of the vermiform appendix. Ann Surg 1937; 106: 135-139.

11. Priego P, Lobo E, Moreno I, et al. Acute appendicitis in an incarcerated crural hernia: analysis of our experience. Rev Esp Enferm Dig 2005; 97: 707-705.

12. Johari HG, Paydar S, Davani SZN, Eskandari S, Johari MG. Left-sided Amyand hernia. Ann Saudi Med 2009; 29: 321-322.

13. Logan MT, Nottingham JM. Amyand’s hernia: a case report of an incarcerated and perforated appendix withina an inguinal hernia and review of the literature. Am Surg 2000; 67: 628-629.

14. Ash L, Hatem S, Ramirez GA, Veniero J. Amyand's hernia: A case report of prospective CT diagnosis in the emergency department. Emerg Radiol 2005; 11: 231-232.

15. Maizlin ZV, Mason AC, Brown C, Brown JA. CT findings of normal and inflamed appendix in groin hernia. Emerg Radiol 2007; 14: 97-100.

16. Luchs JS, Halpern D, Katz DS. Amyand’s hernia: prospective CT diagnosis. J Comput Assist Tomogr 2000; 24: 884-886.

17. Weber RV HZ, Kraal JG. Amyand’s hernia: Etiologic and therapeutic implications of the two complications. Surg Rounds 1999; 22: 552-556.

18. Anagnostopoulou S, Dimitroulis D, Troupis TG, et al. Amyand's hernia: a case report. World J Gastroenterol 2006; 29: 4761-4763.

19. Kahramanca Ş, Kaya O, Güzel H, Özgehan G, Bostancı H, Gürsoy G. Amyand Herni ve Cerrahi: Apendektomi Gerekli mi? Fıtık onarımı nasıl yapılmalı? DEÜ Tıp Fakültesi Dergisi 2013; 27: 75-80.

20. Losanoff JE, Basson MD. Amyand hernia: a classification to improve management. Hernia 2007; 12: 325-326.

21. Ofili OP. Simultaneous appendectomy and inguinal herniorrhaphy could be beneficial. Ethiop Med J 1991; 29: 37-38.

22. Sözen S, Alıcı A, Tükenmez M ve ark. Amyand fıtığı:Olgu serisi ve deneyimimiz. Ulusal Cerrahi Dergisi 2010; 26: 212-215.

23. Burgess PL, Brockmeyer JR, Johnson EK. Amyand Hernia Repaired with Bio-A: A Case Report and Review.J Surg Education 2011; 68: 62- 66.

24. Campanelli G, Nicolosi FM, Pettinari D, Contessini Avesani E. Prosthetic repair, intestinal resection, and potentially contaminated areas: safe and feasible? Hernia 2004; 8: 190-192