A curious case of toddler with hernia and much more

Transverse testicular ectopia (TTE) with fused vas deferens is an extremely rare clinical entity. Herein, we presented a case of a 2 years old patient with left inguino-scrotal swelling associated with pain lasting for 3 days. Clinical examination revealed an empty right hemi-scrotum, a left-sided giant inguino-scrotal swelling. Laboratory tests were normal. Ultrasound imaging (US) of the scrotum demonstrated the presence of both testes in the same left hemi-scrotum with inguinal hernia and enterocele as content. Surgical intervention in suspicion of obstruction was carried out through inguinal incision. There was a congenital inguinal hernia with appendix (type 1-Amyand’s hernia) and cecum as content with two well developed testes on the same side with separate epididymis and vas deferens. Both the testes were united by a mesorchium. Hence, reduction of contents with herniotomy and both the testes were anchored to inner aspect of left thigh one above the other. We reviewed the literature for rare diagnosis of TTE.

Download Full-text

Perforated necrotic appendix in Amyand’s hernia treated with appendicectomy and simple suture repair of the inguinal hernia

BMJ Case Reports ◽

10.1136/bcr-2019-231765 ◽

2019 ◽

Vol 12 (11) ◽

pp. e231765 ◽

Cited By ~ 1

Author(s):

Muhamamd Isfandyar Khan Malik ◽

Joshua Abbas ◽

Paul Shuttleworth ◽

Nafees Qureshi

Keyword(s):

Inguinal Hernia ◽

Amyand’S Hernia ◽

Suture Repair ◽

Small Bowel Mesentery ◽

Good Recovery ◽

Hernia Sac ◽

Blood Tests ◽

Testicular Pain ◽

Scrotal Hernia ◽

Scrotal Swelling

A 50-year-old man was referred to the emergency department by his general practitioner with a tender right-sided irreducible inguinal hernia (previously reducible), right-sided testicular pain and scrotal swelling. Clinical examination revealed a non-reducible, tender right inguinal-scrotal hernia and swollen right scrotum. Blood tests showed raised inflammatory markers. The patient went on to have a CT scan which was reported to show an indirect right inguinal-scrotal hernia possibly containing terminal ileum and small bowel mesentery. The scan also showed increased infiltrate changes within the hernia sac suggesting incarceration with possible early strangulation but no obvious evidence of bowel obstruction. The patient was taken to the operating theatre and found to have a large right inguinal-scrotal hernia containing pus and a perforated necrotic appendix. He went to have an appendicectomy and sutured repair of the hernia. Postoperatively, the patient made a good recovery and was discharged 2 days postsurgery.

Download Full-text

Complicated Amyand’s Hernia in a Neonate

Journal of Neonatal Surgery ◽

10.47338/jns.v3.102 ◽

2014 ◽

Vol 3 (3) ◽

Author(s):

Parkash Mandhan ◽

Talal Al Rayes ◽

Mansour J Ali ◽

Mahmoud Aldhaheri

Keyword(s):

Inguinal Hernia ◽

Vermiform Appendix ◽

Clinical Entity ◽

Amyand’S Hernia ◽

Rare Clinical Entity ◽

Hernia Sac ◽

Surgical Exploration ◽

Dysmorphic Features ◽

Scrotal Swelling

Amyand’s hernia is a rare clinical entity in which the vermiform appendix is present within the inguinal hernia sac. Here, we report a 5-day-old neonate with dysmorphic features referred to us with a tender irreducible right inguino-scrotal swelling. Surgical exploration showed gangrenous appendix with a peri-appendicular abscess in the inguinal hernia sac. Appendectomy and right herniotomy was performed.

Download Full-text

Transverse testicular ectopia with inguinal hernia in an adult—a case report

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00531-z ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Sudhakar Pitchumani ◽

Elamparidhi Padmanaban ◽

Yash Kumar Achantani ◽

Rajasree Dhinadhayalan ◽

Avinesh Varadane

Keyword(s):

Congenital Anomaly ◽

Case Report ◽

Inguinal Hernia ◽

Seminal Vesicle ◽

Vas Deferens ◽

Wide Spectrum ◽

Left Testis ◽

Rare Congenital Anomaly ◽

Transverse Testicular Ectopia ◽

Testicular Ectopia

Abstract Background Transverse testicular ectopia (TTE) is a rare congenital anomaly in which both the testis are in the same hemiscrotum or one testis in the inguinal canal of the same side. It is usually associated with other anomalies such as inguinal hernia, persistent Mullerian duct syndrome (PMDS), true hermaphroditism, and pseudo-hermaphroditism. In this case report, we present a rare case of TTE in an adult patient with fused vas deferens, aplastic right seminal vesicle, and right side inguinal hernia. Case presentation A 33-year-old male came with complaint of severe pain in the scrotum for 2 days with a long-standing history of right inguinoscrotal swelling. Clinical examination revealed a right inguinoscrotal swelling in which right testis was not palpable separately and left testis was palpable at periphery of the left hemiscrotum. Ultrasound imaging and MRI of the scrotum revealed TTE with both testes in the left hemiscrotum, fused vas deferens, right aplastic and left hypoplastic seminal vesicle, right side patent process vaginalis with a non-obstructive, and non-strangulated inguinal hernia. Surgical intervention with transeptal orchidodpexy was advised but not performed due to the patient’s unwillingness. Hence, we recommended an annual follow-up for the same. Conclusion The present case report emphasizes that though TTE is a rare congenital anomaly, it should be considered as a differential diagnosis in patients with an absent testis and/or infertility, and a detailed imaging and biochemical investigation should be employed considering the wide spectrum of associated conditions.

Download Full-text

Amyand’s Hernia Presenting as a Scrotal Abscess – A Rare Presentation in a Newborn

Surgical Case Reports ◽

10.31487/j.scr.2021.02.21 ◽

2021 ◽

pp. 1-3

Author(s):

Prakash Agarwal ◽

Vadyala Akshita Reddy ◽

Prakash Agarwal ◽

Madhu Ramasundaram ◽

Jegadeesh Sundaram ◽

...

Keyword(s):

Inguinal Hernia ◽

Newborn Infants ◽

Amyand’S Hernia ◽

Bowel Loop ◽

Bilateral Inguinal Hernia ◽

Rare Presentation ◽

Intravenous Antibiotics ◽

Perforated Appendix ◽

Scrotal Swelling ◽

The Right

A 26-week-old extreme preterm boy presented with a right hemiscrotal abscess. An ultrasound of the scrotum suggested right epididymo-orchitis. The abscess was drained and appropriate intravenous antibiotics were initiated. One month later, he was diagnosed with a right sided irreducible inguino-scrotal swelling, confirmed as bilateral inguinal hernia with herniating bowel loop on ultrasonography. With this diagnosis, he was planned to undergo a bilateral herniotomy. Intraoperatively, an inflamed and perforated appendix was found herniating into the right sac. The tip of the appendix was adherent to the scrotal wall, where the pus was extruding out. Appendicectomy and bilateral herniotomy was done successfully and histopathology revealed acute appendicitis. Baby recovered well postoperatively. Owing to the fragile nature of tissues in neonates, accession of planes was challenging. Amyand’s hernia presenting as a scrotal abscess is extremely rare in newborn infants, and less than 5 cases have been reported till date.

Download Full-text

Therapeutical and Pharmaco-Chemical Conduct for Amyand Hernia

Revista de Chimie ◽

10.37358/rc.19.12.7736 ◽

2020 ◽

Vol 70 (12) ◽

pp. 4224-4228

Keyword(s):

Inguinal Hernia ◽

Surgical Treatment ◽

Polypropylene Mesh ◽

Surgical Procedure ◽

Preoperative Diagnosis ◽

Vermiform Appendix ◽

Amyand’S Hernia ◽

Amyand Hernia ◽

The Right

One of the rare findings regarding the hernial sac is the vermiform appendix. This pathology, defined as Amyand’s hernia, occurs in almost 1% of all inguinal hernia cases (0.19-1.7%). Usually, it is diagnosed intraoperatively, because the preoperative diagnosis is very difficult. We report the case of a 56-year-old man with a voluminous mass in the right inguinal-scrotal region. During the surgical procedure, an Amyand’s hernia was identified and we performed reduction of the hernia, herniorrhaphy and Lichtenstein Tension-Free Repair with polypropylene mesh. The case that we presented was type 1 according to Losanoff and Basson’s classification, but also to Rikki modified classification, with a very controversial management. Clinical evaluation and surgeon’s experience are the base of the surgical treatment. Keywords: vermiform appendix, inguinal hernia, surgical treatment

Download Full-text

COMPLICATED AMYAND’S HERNIA IN A NEONATE MIMICKING INGUINAL ABSCESS

Khyber Medical University Journal ◽

10.35845/kmuj.2019.17328 ◽

2019 ◽

Keyword(s):

Inguinal Hernia ◽

Vermiform Appendix ◽

Amyand’S Hernia ◽

Normal Appendix ◽

Lower Quadrant ◽

Hernia Sac ◽

Incarcerated Inguinal Hernia ◽

Scrotal Swelling ◽

Right Lower Quadrant ◽

Separate Incision

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.

Download Full-text

Functional testicular torsion secondary to an incarcerated inguinal hernia in a 4-month old: complete recovery at 18-hours

Journal of Surgical Case Reports ◽

10.1093/jscr/rjab022 ◽

2021 ◽

Vol 2021 (2) ◽

Author(s):

Gregory M Taylor ◽

Christian C Strachan

Keyword(s):

Inguinal Hernia ◽

Testicular Torsion ◽

Pediatric Patients ◽

Complete Recovery ◽

Cord Compression ◽

Acute Scrotum ◽

Indirect Inguinal Hernia ◽

Incarcerated Inguinal Hernia ◽

Scrotal Swelling ◽

Urological Emergencies

Abstract One of the most common urological emergencies encountered in pediatric patients in the emergency department (ED) is the acute scrotum. We present the case of a 4-month-old male that presented to our community ED with scrotal swelling and vomiting of 16-hours duration. He was diagnosed with a functional testicular torsion from an incarcerated inguinal hernia, transferred to a hospital with pediatric urological capabilities and was taken to the operating room ~2 hours later. His hospital course was unremarkable, and he was discharged on day 3, having made a full recovery without any loss of bowel or testicle. There have only been a handful of cases in the literature of a pediatric patient presenting with a functional testicular torsion as a result of spermatic cord compression from an indirect inguinal hernia, with no reported cases of complete salvage at nearly 18 hours since symptom onset.

Download Full-text