PEDİATRİK YAŞTA AMYAND HERNİSİ: TEK CERRAH DENEYİMİ

Amaç Amyand hernisi, inguinal herni kesesinde apendixvermiformisin varlığı ile karakterize nadir görülen birherni türüdür. Çoğunlukla inkarsere inguinal herni öntanısı ile ameliyat edilen hastalarda tesadüfen tanı ko nulur. Bu nadir patoloji hakkındaki deneyimin sunul ması amaçlandı. Gereç ve Yöntem Bu çalışmada 2011-2017 tarihleri arasında tek birçocuk cerrahı tarafından ameliyat edilen on Amyandhernili çocuk hastanın retrospektif bir analizi yapıldı.Hastaların demografik özellikleri (yaş, cinsiyet), baş vuru şikayetleri, tedavi yöntemleri, histopatolojik bul guları ve postoperatif sonuçları değerlendirildi. Bulgular Amyand hernili tüm hastalar erkekti. Yaş ortalaması12.02 aydı (17 gün-8 yaş). Hepsinde sağ inguinal her ni mevcuttu. Hastaların 4’üne inkarsere inguinal herniön tanısıyla acil cerrahi uygulandı. Geri kalan 6 has ta, elektif herni onarımı sırasında tesadüfen tanı aldı.Dokuz hastaya konvansiyonel herni onarımı yapıldıve sadece bir hasta laparoskopi kullanılarak ameliyatedildi. Ameliyat bulguları 7 hastada normal apendiksve 3 hastada inflame apendiksti. Apendiksi fıtık ke sesine yapışık olan 3 hastanın ikisinde inflame apan disit birinde lenfoid hiperplazi saptandı. Dört hastadainguinal herni onarımı sırasında apendektomi, diğer6 hastada apendektomi yapılmadan herni onarımı ya pıldı. Hiçbir hastada tekrarlayan fıtık görülmedi.Sonuç Sağ inguinal hernisi olan hastaların ayırıcı tanısındaAmyand hernisi unutulmamalıdır. Fıtık kesesine yapı şan apendiksin inflamasyon durumu uygun bir tedavikararı verebilmek için dikkatle değerlendirilmelidir.

AMYAND’S HERNIA IN PEDIATRIC AGE:A SINGLE SURGEON EXPERIENCE

Objective Amyand's hernia is the presence of appendix in thehernia sac and rarely seen. The diagnosis is mostlymade incidentally during the operation performed dueto the incarcerated inguinal hernia. It is aimed to pre sent the experience about this rare pathology.Materials and Methods A retrospective analysis of 10 children with Amyand'shernia operated by a single pediatric surgeon betwe en 2011 and 2017 was performed. Demographic fea tures (age, gender), complaints, treatment methods,histopathological findings and postoperative resultswere evaluated. Results All patients were male. The average age of patientswas 12.02 months (17 days-8 years) and all had aright inguinal hernia. Emergency surgery was perfor med in 4 of the patients with an initial diagnosis ofincarcerated inguinal hernia. The remaining 6 patientswere diagnosed incidentally during elective herniop lasty. While 9 patients were treated with conventionalhernia repair, only one underwent laparoscopy. Surgi cal findings included 7 normal appendices ve 3 infla med appendices. Of the 3 patients with appendix ad hered to the hernia sac, 2 has appendicitis and 1 haslymphoid hyperplasia. Appendectomy was performedduring inguinal hernia repair in 4 patients and herniarepair was performed in 6 patients without appende ctomy. Recurrent hernias were not observed in anypatients. Conclusion Amyand's hernia should be kept in mind in the diffe rential diagnosis of patients with right inguinal hernia.The inflammation status of appendix adhering to thehernia sac should be carefully evaluated for an ap propriate treatment decision.

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