Amyand’s hernia is a rare form of hernia in which the vermiform appendix is present within the inguinal hernia sac. Here, we report a 12 days-old neonate with features of inguinal abscess referred to us with a tender irreducible right inguino-scrotal swelling. On examination, there was tender swelling right inguino-scrotal region with abdominal wall edema extending up to right lower quadrant. Surgical exploration showed long appendix with a gangrenous 1/3 of distal appendix, peri-appendicular abscess in the inguinal hernia sac. Appendectomy and right herniotomy was performed. Amyand’s hernia presentation is variable: from a reducible inguinal hernia containing a normal appendix, to acute abdomen due to perforation of acute appendicitis secondary to incarceration. Only imaging can verify the contents of an incarcerated inguinal hernia. Surgical approach varies depending upon findings. In our case, we used separate incision for appendectomy because of a very long appendix and high lying caecum in right hypochondrium with difficulty to bring base of appendix down for ligation.
Torsion of an Indirect Hernia Sac Causing Acute Scrotal Swelling in a Child
