Incarcerated Amyands Hernia With Acute Appendicitis: A Case Report

Abstract

Amyands hernia is a rare condition defined as the inclusion of the appendix in an inguinal hernia sac, which becomes even rarer in a concomitant case of acute appendicitis. In patients presenting with an incarcerated inguinal hernia and underlying acute appendicitis, the obvious symptoms of the incarceration can mask those of appendicitis. This can complicate management, often leading to a missed pre-operative diagnosis and an emergent intraoperative finding often requiring immediate repair. For this study, we present one case of Amyands hernia that was diagnosed intraoperatively. The patient is a 58-year-old African American male who presented to his primary care physician for worsening groin pain, later to undergo surgery for an incarcerated hernia. As described, in instances of Amyands hernia, signs of acute appendicitis may not be initially recognized as they are overshadowed by apparent signs of bowel obstruction. This was the case while our patient was in surgery, as signs suggestive of acute appendicitis were discovered and the patient received an appendectomy in addition to hernia repair. The diagnosis of Amyands hernia with acute appendicitis has been reviewed in other publications and was found to be a rare condition. As the occurrence rate is so low, there are different methods of management for specific classifications of Amyands hernia. The case report, background research, statistics, classifications, and specific managements are being presented within this article. The purpose of this study is to evaluate our case against the published data and the procedural recommendations.




J Med Cases. 2015;6(12):592-595
doi: https://doi.org/10.14740/jmc2284w