Here we describe a case of an amyands hernia in a patient who presented in our outpatient clinic with an irreducible rightsided inguinal hernia. When a normal, inflamed or perforated appendix is found as a content in an incarcerated inguinal hernia, it is called the amyands hernia 1. Amyand hernias have been described in case reports in the literature and are a rare occurrence in the career of a surgeon. The operation was performed on december 6, 1735, at st. Preoperative diagnosis of amyands hernia by ultrasound. An indirect inguinal hernia is a congenital lesion. Amyands hernia is characterized by the presence of an inflamed, noninflamed or perforated appendix within the sac of an inguinal hernia. Incarcerated amyand hernia fatih ciftci, ibrahim abdulrahman fatih ciftci, ibrahim abdulrahman, department of surgery. Inguinal hernias occur when part of the intestine pokes through an opening or weak area of the abdomen muscle wall and into the groin area. Its diagnosis is very difficult in the preoperative period. Amyands hernia, state of the art and new points of view. To our knowledge, the presence of an appendiceal carcinoid tumor presenting as a case of incarcerated amyand hernia has not been reported in the literature. Preoperative diagnosis plays an important role in the treatment planning.
Amyands hernia is an inguinal hernia containing vermiform appendix. Amyand hernia is a rare disease seen in approximately 1% of all hernias, complications of it, like acute appendicitis, or perforated appendicitis are even more rare, about 0. Honor society of nursing stti an amyands hernia is caused by the appendix poking into an inguinal hernia. The true incidence of this hernia is still not discernible in view of its rarity. Claudius amyand, surgeon to king george ii, was the first to describe in 1736 the presence. The world guidelines for groin hernia management no statements chapter 2 risk factors for the development of inguinal hernias in adults kq02. The presence of the vermiform appendix contained in the hernia sac, or an amyands hernia, is exceedingly rare, occurring in 1% of inguinal hernia patients. Since then, the presence of the appendix in an inguinal hernia sac has been referred to as amyands hernia. Honor society of nursing stti surgery is needed to treat an amyands hernia. The aetiology of amyands hernia is often questioned in literature and there is no standard protocol for the management of amyands hernia. An amyands hernia is defined by the presence of a vermiform appendix within an inguinal hernia sac. Amyands hernia is a seldom surgical pathology whereby there is inclusion of the appendix vermiformis within the groin hernia sac.
Amyands hernia is defined as the herniation of the whole or a part of appendix vermiformis into an inguinal hernia sac. The presence of an inflamed or gangrenous appendix increases the rate of complication, particularly increasing the rate of wound infection. That was the first appendectomy ever reported in the literature. It is a rare phenomenon, with only 1% of all femoral hernias containing the appendix and usually found incidentally at surgery, and only 0. Amyand hernia repair with mesh and appendectomy springerlink. A case of amyands hernia, which was recently managed by the authors, was. It is a rare disease and diagnosis is usually made during the perioperative because in most cases are mistaken for incarcerated inguinal hernia. The presence of the appendix within an inguinal hernial sac is referred to as amyands hernia and is an uncommon condition. The presence of appendix vermiformis in an inguinal hernia sac is referred to as amyands hernia and is a rare condition.
An amyands hernia refers to the presence of an appendix within an inguinal hernia sac. Most of these cases are not diagnosed preoperatively and the surgical approach is dependent on the type present and associated intraoperative findings. A 75yearold caucasian man presented with incarceration of vermiform appendix in inguinal hernia sac. Amyands hernia is very rare, constituting about 1% of all inguinal hernia patients and 0. The presence of the vermiform appendix in the sac of an inguinal hernia was defined first by claudius amyand, an english surgeon eighteenth. Dear editor, the presence of the appendix within an inguinal hernia is referred to as amyands hernia. The incidence of normal appendix within an inguinal hernia sac is estimated to be approximately 1%, whereas acute appendicitis presenting in an inguinal hernia is an uncommon event 0. Amyands hernia as a sliding component of inguinal hernia. In 1735 amyand described the presence of a perforated appendix within the hernial sac of an 11yearold boy who had undergone successful appendicectomy. While laparoscopic technique is the most accepted approach, few prospective studies have been completed comparing laparoscopic versus robotic techniques for hernia repair and. Indirect inguinal hernia an indirect inguinal hernia occurs when any intraabdominal structure protrudes through the deep inguinal ring entering the inguinal canal. Amyand hernia is rare condition and has been described as the presence of appendix vermiformis in an inguinal hernia sac. A vermiform appendix in an inguinal hernia, inflamed or not, is known as amyands hernia. An inguinal hernia may content the urinary bladder, an ovary, the fallopian tube, diverticulitis of the colon, or the vermiform appendix.
Management involves a laborious surgical technique, and its definitive treatment will depend on the surgeons experience and clinical scenario. A case report sherif monib, bassem amr, ahmed hamad, hany faiz, ahmed farghaly abstract introduction. Amyand s hernia is a rare form of an inguinal hernia less than 1% of inguinal hernias which occurs when the appendix is included in the hernial sac and becomes incarcerated. Amyand hernia is a rare disease seen in approximately 1% of all hernias. Amyand hernia was first described by claudius amyand in the literature in 1735. Amyands hernia is a rare clinical entity that is difficult to diagnose preoperatively. Amyands hernia is a type of sliding inguinal hernia where the vermiform appendix lies in the hernial sac. Pdf abstract amyands hernia is defined as when the appendix is trapped within an inguinal hernia. Amyands hernia usually presents as an incarcerated or strangulated hernia, but its presentation can be quite variable. Amyand hernia is a rare condition and represents two of the most common diseases a general surgeon has to face hernia and appendicitis. While inguinal hernias are commonly seen, amyand hernias represent 0.
Evaluation of the incidence of inguinal hernia with amyand. We retrospectively studied 963 caucasian patients with inguinal hernia who were admitted to our surgical department over a 12year period. Acute appendicitis in an inguinal hernia that has been called as amyands hernia since the day on which claudius amyand has described the condition. Claudius amyand, surgeon to king george ii, was the first to describe in 1736 the presence of a perforated appendix within the hernial sac of an 11yearold boy who had undergone successful appendectomy. Here we present a case series of four men with amyands hernia. Amyands hernia is defined as when the appendix is trapped within an inguinal hernia. Diagnosis is usually made at the time of surgery, which is usually indicated in all incarcerated hernias. He was the f irst surgeon to perform an appen dectomy in 1 735, in a child that had perf orate d appendicitis within an incarcerated hernia. We discuss a variety of strategies to consider if such a rare presentation is encountered as well as a possible aetiology. Amyands hernia ah is an inguinal hernia containing the vermiform appendix, with an incidence between 0. A hernia is defined as the protrusion of a viscus or part of a viscus through the walls of its containing cavity. We report an unusual case of an amyands hernia presenting as an enlarging painful mass on the right lateral edge of the mons pubis, resembling an abscess. Lee yt, wu hs, hung mc, lin st, hwang ys, huang mh 2006 ruptured appendiceal cystadenoma presenting as right inguinal hernia in a patient with left colon cancer. Simultaneous laparoscopic total extraperitoneal inguinal.
During the surgery, amyand found a pin within the appendix, which was encrusted with stone. Amyands hernia is a rare form of an inguinal hernia less than 1% of inguinal hernias which occurs when the appendix is included in the hernial sac and becomes incarcerated. During surgery, an appendectomy is performed to remove the appendix from the inguinal hernia. It is a condition in which a normal, inflamed, perforated or incarcerated appendix is located in the inguinal hernia sac. This uncommon finding occurs in less than 1% of all right side inguinal hernias. We report a case of this rare condition, diagnostic findings, and management considerations. Amyands herniaa vermiform appendix presenting in an. A classification to improve management find, read and cite all. Contents within the hernia sac are variable and in rare cases, the hernia sac contains the vermiform appendix termed amyands hernia. Pdf on jun 30, 2015, turgay simsek and others published amyands hernia.
Amyands hernia presenting as an unusual inguinal mass. We present here a case even more rare of a giant leftsided inguinoscrotal amyand hernia with appendiceal abscess and the presence in the sac of a tract of the ascending colon, last ileal loops, a. This is an exceedingly rare presentation and most of the cases are diagnosed incidentally during surgery. Amyands hernia, report of three cases and discussion of. A 53yearold man with an amyand hernia with indirect and. Incarcerated amyand hernia baishideng publishing group. Amyands hernia may be included in the sac of an inguinal hernia3,4. Letter to editor find, read and cite all the research you need on researchgate. While the incidence of this type of hernia is rare, the appendix may become incarcerated within amyands hernia and lead to further complications such as strangulation and perforation. Its incidence among cases of groin hernia is less than 1%. The incidence of acute appendicitis in an inguinal hernia is 0, % of all cases with acute appendicitis. Claudius amyand described the first case of a perforated appendix within the hernial sac in 1735 after his patient had undergone a successful appendectomy.
An inguinal hernia is termed an amyand hernia if the hernia sac comprises or contains the appendix. The preoperative diagnosis of this condition is uncommon. In conclusion, amyands hernia is an extremely rare condition, and is often misdiagnosed. Appendicitis in amyands hernia is believed to be caused by extra luminal compression and can mimic appendicitis or complicated inguinal hernia. Doppler ultrasound should be used to check the vascularity of the herniated parts. Amyands hernia is a rare pathology that have been identified many centuries ago, and precisely for the low incidence previously.
Checklist of responsibilities for the scientific editor of this article publishing process of this article. Ultrasound plays an important role in hernia diagnosis and showing the contents of the hernia sac. Amyand s hernia is a seldom surgical pathology whereby there is inclusion of the appendix vermiformis within the groin hernia sac. The condition is an eponymous disease named after a french surgeon, claudius amyand 16601740, who performed the first successful appendectomy in 1735. Amyand hernia is a rare form of an inguinal hernia in which the vermiform appendix is located within the hernial sac.
The last one was described in first time by claudius amyand in 1736 1. Amyand s hernia may be included in the sac of an inguinal hernia 3,4. We present a case of a preoperatively diagnosed amyands hernia in a man who underwent treatment by simultaneous laparoscopic totally. The clinical presentation of incarcerated inguinal hernia generally masks the symptoms and signs of acute appendicitis, which renders preoperative identification difficult. The amyand hernia with normal appendix is a rare event and even more rare is a hernia with appendicitis often diagnosed only intraoperatively. Although an inguinal hernia is common, amyands hernia has an incidence of 1% and is complicated by acute appendicitis in 0.
Its incidence in the adult population is about 1% and it mostly manifests as an unexpected condition during surgery 1. Then the inguinal hernia is repaired through hernioplasty or herniorrhaphy. In rare cases, the appendix, which is located at the end of the. Acute or perforated appendicitis can complicate ah. Inguinal hernia repair is the most common procedures in general surgery. The incidence of amyand hernia is approximately 1% of types inguinal hernia. We report the 15th case of a left side amyands hernia that was diagnosed preoperatively on a contrast enema.
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