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      A condition that should be kept in mind in incarcerated hernia: Amyand’s hernia

      case-report

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          Abstract

          As a complication of inguinal hernia, incarcerations are often seen in emergency services. Incarceration is an acute complication of inguinal hernia presenting as surgical emergency. The sac of inguinal hernia most frequently contains omentum and intestine but sometimes organs such as appendix and Meckel’s diverticulum can also be seen in the hernial sac. We present a case of Amyand’s hernia containing appendix in the incarcerated herniated sac.

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          Amyand's hernia: a report of 18 consecutive patients over a 15-year period.

          H Sharma, Ravindra K. Gupta, J M Memon … (2007)
          The presence of a vermiform appendix in an inguinal hernia sac is termed Amyand's hernia. It may present as a tender inguinal or inguino-scrotal swelling and is often misdiagnosed as an incarcerated or strangulated hernia. The purpose of this study was to review the management of Amyand's hernia at a single institution since 1991. A retrospective analysis was undertaken of 18 consecutive patients with an Amyand's hernia operated upon at our institution from 1991 to 2005. Patients' demographics, treatment and postoperative outcome were analysed. There were 17 men and one woman. Their median age was 42 years. None of the patients was diagnosed preoperatively. The commonest presenting symptom was painful inguinal or inguino-scrotal swelling (83%). All patients, therefore, underwent emergency surgery with a presumptive diagnosis of either incarcerated or strangulated inguinal hernia. Operative findings included 11 normal appendices, four inflamed appendices and three perforated appendices in the inguinal hernial sac. Patients with a normal appendix (n = 11) had a mesh hernia repair without an appendicectomy. The rest of the patients (n = 7) with an abnormal appendix underwent emergency open appendicectomy followed by Bassini's sutured hernia repair. One patient died in the postoperative period of pneumonia. Only one recurrent hernia has been detected, with a median follow-up time of 6.4 years. The inflammatory status of the appendix determines the type of hernia repair and the surgical approach. Incidental appendicectomy in the case of a normal appendix is not favoured.
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            The unified theory of hernia formation.

            R Bendavid (2004)
            The perusal of surgical journals suggests that the etiology and the treatment of hernias are still based on the understanding of a simple mechanical defect, an idiopathic happenstance requiring a reliable hernia repair, preferably with a prosthetic mesh or device. The need for additional elucidation does not constitute an aim that is pervasive in the surgical community or with the corporate manufacturers of surgical implements. This may well be because surgeons are not trained scientists and laboratory workers. Fortunately, several disciplines are injecting a healthy dose of curiosity matched by ingenuity. Among these contributors, we can count anatomists, electron microscopists, biochemists, organic chemists, pathologists, geneticists, and molecular biologists, who have looked at collagen, enzymes, tobacco smoke, congenital diseases, and chromosomal defects. Every aspect of the researchers' work has identified and converged onto a final common organ: collagen. It is the pathological changes in collagen that set the stage for the development of a hernia. The multiple theories on mechanisms of hernia formation have, at last, melded into one single Unified Theory of hernia formation.
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              Amyand's hernia: history, imaging, and management.

              Alexander Allins, S Milanchi (2008)
              Amyand's hernia is an inguinal hernia containing vermiform appendix. We report a case of this rare condition, diagnostic findings, and management considerations. A short review and history of Amyand's hernia is presented as well. A literature search from Medline was done, and the published articles were reviewed. A case of Amyand's hernia, which was recently managed by the authors, was studied and the data reviewed. Diagnosis of the Amyand's hernia is usually made intraoperatively. The majority of the existing literature recommends doing open or laparoscopic appendectomy with open repair of the inguinal hernia, although some authors advise mesh repair of the hernia if the appendix is normal. Amyand's hernia can be a challenge for the surgeon. We recommend laparoscopic appendectomy and open repair of the inguinal hernia without using mesh.
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                Author and article information

                Journal
                Journal ID (nlm-ta): North Clin Istanb
                Journal ID (iso-abbrev): North Clin Istanb
                Title: Northern Clinics of Istanbul
                Publisher: Kare Publishing (Turkey )
                ISSN (Electronic): 2536-4553
                Publication date Collection: 2017
                Publication date (Electronic): 10 May 2017
                Volume: 4
                Issue: 1
                Pages: 78-80
                Affiliations
                [1 ]Department of General Surgery, Elazig Training and Research Hospital, Elazig, Turkey
                [2 ]Department of Emergency Clinic, Elazig Training and Research Hospital, Elazig, Turkey
                Author notes
                Correspondence: Dr. Mehmet Bugra BOZAN. Elazig Egitim ve Arastirma Hastanesi, Genel Cerrahi Klinigi, 23100 Elazig, Turkey. Tel: +90 424 - 238 10 00 e-mail: bbozan@ 123456yahoo.com
                Article
                Publisher ID: NCI-4-78
                DOI: 10.14744/nci.2015.87609
                PMC ID: 5530163
                SO-VID: 08dcfd97-c6f1-445f-8b9c-ef71876ace19
                Copyright © Copyright: © 2017 by Istanbul Northern Anatolian Association of Public Hospitals
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

                History
                Date received : 11 October 2014
                Date accepted : 01 September 2015
                Categories
                Subject: Case Report

                Keywords: amyand’s hernia,groin hernia,incarseration
                Data availability:
                Keywords: amyand’s hernia, groin hernia, incarseration

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