Abstract

CASE STUDY OF AMYAND HERNIA AND EXPLORATORY LAPAROTOMY WITH APPNDICECTOMY WITH RT INGUINAL HERNIORRHAPHY

*Anand Prajapati, Dr. Nitin Nalawade and Dr. Dhanaraj Gaikwad

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Abstract

Amyand’s hernia is defined as an inguinal hernia that contains the appendix within the hernia sac. In 1735, C. Amyand first described an 11-year-old boy with an incarcerated inguinal hernia containing a perforated appendix. Subsequently, this type of hernia was named Amyand’s hernia, which was rarely encountered in clinical practice. Amyand’s hernia occurs in only 1% (0.19–1.7%) of all inguinal hernia cases. Moreover, Amyand’s hernia is classified into four subtypes regarding the clinical symptoms and the situation of the appendix. There are no inflammatory changes in the groin of type 1 Amyand’s hernia; type 2 Amyand’s hernia is those in which the septic changes are confined to the hernia sac; type 3 Amyand’s hernia represents a scenario where the sepsis has spread beyond the hernia sac; type 4 Amyand’s hernia includes acute appendicitis and other abdominal lesions. The appendix within the hernia can be either normal or inflamed, in which 0.13% of cases have appendicitis. Notably, the perforation of the appendix could lead to a dramatic increase in the mortality rate (15–30%) due to severe abdominal sepsis. Commonly, the diagnosis of Amyand's hernia was made intraoperatively and few cases could be diagnosed before surgery. Besides, current management of Amyand's hernia remains controversial since different strategies should be tailored to different individuals. In this study, we reported six cases of Amyand's hernia and detailed different managements, aiming to provide a reference for the surgical treatment of Amyand's hernia.

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