Clinical Reviews & Cases

Abstract

A Case Report of Amyand's Hernia in a 55-year-old Saudi Male

Ahmed Fathy Mustafa, Adel Ahmed Alfayez, Abdulmajeed Mubarak Alshammari, Bayan Abdulkarim Alsamaan

Introduction: Amyand’s hernia is a rare entity. Basically, means that the vermiform appendix is located within the hernial sac and its contents. The purpose of this report is to share our experience with healthcare community about similar rare events and to discuss the best modality approaches.

Presentation of case: 55 years old male, complained of: Vomiting, abdominal distension followed by abdominal pain and absolute constipation. His condition becomes more progressive till he developed bilious vomiting and severe tense abdominal distension. He had history of exploratory laparotomy 40 years ago. On examination, there is a visible midline laparotomy scar along with right irreducible inguinal bulging, abdominal X-ray erect was taken and showed “multiple air fluids levels”. Diagnosis of right obstructed inguinal hernia was made and he underwent right inguinal hernia repair. Infrequent findings were encountered during surgical course and managed based on recent guideline.

Discussion: A 55-year-old male, went through inguinal hernia repair with unexpected intraoperative findings. Although it's rare, but important to be discussed in relevant literatures. Amyand’s hernia has variable types of presentations, with acute appendicitis may be faced. In our article, we discuss the pathogenesis, types of presentations and the incidence of A. hernia. Also, diagnostic modalities, recent management guidelines are discussed here.

Conclusion: Intraoperative findings of perforated vermiform appendix inside a hernial sac, is difficult to be assessed preoperatively. The article highlights the importance of considering unusual findings during surgery in patients who are going for hernia repair irrespective of their ages and presentations.

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