Amyand's hernia and acute appendicitis: Case presentation in Basic Hospital of Chone

Present the case of a 66-year-old male patient, with a history of right inguinal hernia, who was referred to the emergency room at the IESS de Chone Basic Hospital in the north of the Manabí province, Ecuador, with symptoms of Abdominal pain of more than 24 hours of evolution located in the right iliac fossa and inguinal region on the same side, in the physical examination the hernia was impossible to reduce, so he was taken to the operating room, in the intervention the cecal appendix was found swollen within the hernial sac, a condition known as Amyand's hernia.

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A rare case of Amyand’s hernia with acute appendicitis in a 69-year-old woman: a case report

Iberoamerican Journal of Medicine ◽

10.53986/ibjm.2020.0065 ◽

2020 ◽

Vol 2 (4) ◽

pp. 385-387

Author(s):

Antonio Gligorievski ◽

◽

Keyword(s):

Case Report ◽

Inguinal Hernia ◽

Acute Appendicitis ◽

Rare Case ◽

Ct Scanning ◽

Amyand’S Hernia ◽

Hernia Sac ◽

History Of ◽

The Right ◽

Surgical Clinic

Introduction: Amyand’s hernia is an extremely rare and atypical hernia that is difficult to diagnose clinically characterized by the herniation of the appendix into the inguinal sac. The aim of this report is to describe a case of Amyand’s hernia and highlights the importance of early CT scanning in reaching the exact and early diagnosis of Amyand’s hernia. Case report: We present a rare case of a 69-year-old female patient with a history of intermittent pain in the right inguinal region is see at the emergency surgical clinic. The patient underwent a CT scan of the abdomen and a small pelvis, and an inflamed appendix was diagnosed. The inflamed appendix is herniated in the inguinal hernia sac. Computed tomography was the only modality to diagnose the hernia sac contents preoperatively. Discussion: The reported incidence of Amyand’s hernia is less than 1% of all adult inguinal hernia cases. Acute appendicitis in Amyand’s hernia is even less common, with 0,1% of all cases of acute appendicitis. This hernia may be present without symptoms until the inflammation of the appendix may lead to incarceration, strangulation, necrosis, perforation, or rupture. Early symptoms include tenderness and inguinal swelling. Conclusions: Computer tomography helps make an accurate and timely diagnosis of Amyand’s hernia, thus avoiding complications from delayed surgery.

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Caecal Epiploic Appendagitis Masquerading Clinically as an Acute Appendicitis: A Case Report and Brief Literature Review

Case Reports in Surgery ◽

10.1155/2019/6508642 ◽

2019 ◽

Vol 2019 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Tallat Ejaz ◽

Eltaib Saad ◽

Andik Nabil ◽

James Slattery

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Iliac Fossa ◽

Lower Abdominal Pain ◽

Good Health ◽

Final Diagnosis ◽

Epiploic Appendagitis ◽

Rebound Tenderness ◽

History Of ◽

The Right

A 46-year-old female presented to our emergency department (ED) with a 2-day history of right lower abdominal pain which was associated with nausea and anorexia. Abdominal examination revealed tenderness in the right iliac fossa (RIF) with rebound tenderness and a localized guarding. Urine dipstick was normal, and the pregnancy test was negative. Her laboratory investigations were significant only for a CRP of 16.6. A presumptive clinical diagnosis of acute appendicitis was suggested based on the given history and relevant physical signs. However, an abdominal computed tomography (CT) scan revealed an epiploic appendagitis of the caecum with a normal-looking appendix. She was managed conservatively and responded well and was discharged after 2 days in good health. Though being a relatively rare case of acute localized right-sided lower abdominal pain, caecal epiploic appendagitis should be considered as one of the differential diagnoses with the final diagnosis reached usually by the radiological findings due to the nonspecific nature of clinical and laboratory features.

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Left-side incarcerated Amyand’s hernia with appendix and caecum provoke by early banana diet: a case report

BMC Gastroenterology ◽

10.1186/s12876-021-01752-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Supangat ◽

Henggar Allest Pratama ◽

Nanda Eka Sri Sejati ◽

Brenda Desy Romadhon ◽

Ina Sulistyani

Keyword(s):

Inguinal Hernia ◽

Amyand’S Hernia ◽

Early Feeding ◽

Incarcerated Hernia ◽

Hernia Sac ◽

Case Presentation ◽

Common Location ◽

History Of ◽

The Common ◽

The Right

Abstract Background Amyand’s hernia was an unusual condition defined by the presence of an appendix located in the inguinal hernia sac. Its prevalence was 1% of all inguinal hernia in children. The clinical manifestation of Amyand’s hernia was depending on hernia’s stage, an incarcerated hernia will present with an inguinal mass following by pain and motility disorder. It could lead to abdominal distention in the late stage. The common location of Amyand’s hernia was on the right side, the left side was uncommon. Early feeding on infants could provoke symptoms of bowel obstruction (SBO). More than 76% of infants in Java, Indonesia was given banana as solid food in infants before six months old. There is a correlation between the early banana diet and SBO. Amyand’s hernia could present as morbidity of early banana diet. Case presentation We describe a case of two months old infant present with an incarcerated left inguinal hernia and history of early banana diet that performed herniotomy procedure. During the operation, we found left-side incarcerated Amyand’s hernia with appendicitis, excoriation caecum, and sticky banana mass. Conclusion This case suggest the possibility of early feeding of banana diet may provoke incarceration of an inguinal hernia and if the incarcerated hernia content contains the appendix, then an Amyand's hernia.

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Appendicitis: a rare adverse event in colonoscopy

BMJ Case Reports ◽

10.1136/bcr-2021-242523 ◽

2021 ◽

Vol 14 (7) ◽

pp. e242523

Author(s):

Samer Al-Dury ◽

Mohammad Khalil ◽

Riadh Sadik ◽

Per Hedenström

Keyword(s):

Emergency Department ◽

Adverse Event ◽

Abdominal Pain ◽

Acute Appendicitis ◽

Physical Examination ◽

De Novo ◽

Perforated Appendicitis ◽

Lower Quadrant ◽

The Right ◽

Right Lower Quadrant

We present a case of a 41-year-old woman who visited the emergency department (ED) with acute abdomen. She was diagnosed with perforated appendicitis and abscess formation on CT. She was treated conservatively with antibiotics and discharged. On control CT 3 months later, the appendix had healed, but signs of thickening of the terminal ileum were noticed and colonoscopy was performed, which was uneventful and showed no signs of inflammation. Twelve hours later, she developed pain in the right lower quadrant, followed by fever, and visited the ED. Physical examination and blood work showed signs consistent with acute appendicitis, and appendectomy was performed laparoscopically 6 hours later. The patient recovered remarkably shortly afterwards. Whether colonoscopy resulted in de novo appendicitis or exacerbated an already existing inflammation remains unknown. However, endoscopists should be aware of this rare, yet serious complication and consider it in the workup of post-colonoscopy abdominal pain.

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Torsion of a parasitic leiomyoma: a rare but important differential in women presenting with lower abdominal pain

BMJ Case Reports ◽

10.1136/bcr-2019-232797 ◽

2021 ◽

Vol 14 (1) ◽

pp. e232797

Author(s):

Clemmie Stebbings ◽

Ahmed Latif ◽

Janakan Gnananandan

Keyword(s):

Abdominal Pain ◽

Iliac Fossa ◽

Lower Abdominal Pain ◽

Sudden Onset ◽

Greater Omentum ◽

Caribbean Woman ◽

History Of ◽

Right Iliac Fossa Pain ◽

The Right ◽

Fat Stranding

A 39-year-old multiparous Afro-Caribbean woman attended the emergency department with sudden-onset severe right iliac fossa pain. Her inflammatory markers were mildly elevated. Computerised tomography of the abdomen demonstrated features of fat stranding in the right iliac fossa suspicious of acute appendicitis. The scan also noted uterine leiomyomas. The patient was taken to theatre for an emergency diagnostic laparoscopy where her appendix was found to be macroscopically normal. A necrotic heavily calcified parasitic leiomyoma was seen in the right adnexa, free of the uterus and adherent to the greater omentum on a long torted pedicle. The parasitic leiomyoma was successfully removed piecemeal laparoscopically. Complications of leiomyomas, namely, torsion and necrosis, are important differentials in women presenting with sudden-onset lower abdominal pain. A history of sudden-onset severe lower abdominal pain with a background of known leiomyoma should prompt the clerking surgeon to consider a complication of leiomyoma as part of the differential diagnoses.

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Abdominal aortic aneurysm and acute appendicitis: a case report and review of the literature

Journal of Medical Case Reports ◽

10.1186/s13256-021-02703-x ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Rubén Peña ◽

Sergio Valverde ◽

José A. Alcázar ◽

Paloma Cebrián ◽

José Ramón González-Porras ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Acute Appendicitis ◽

Iliac Fossa ◽

Perforated Appendicitis ◽

Case Presentation ◽

Abdominal Symptoms ◽

Abdominal Aortic ◽

The Right ◽

The Relationship

Abstract Background Abdominal aortic aneurysm and acute appendicitis occur relatively frequently in elderly patients. However, the co-occurrence of the two pathologies is very rare and serious. Case presentation We present the case of an elderly Caucasian patient who was aware of having an abdominal aortic aneurysm but refused treatment and was subsequently admitted to the hospital’s emergency department with acute abdominal symptoms. A computed tomography scan raised the possibility of complication due to the characteristics of the aneurysm. The patient then agreed to emergency surgery. Laparotomy revealed the existence of an acute perforated appendicitis with a significant abscess in the right iliac fossa and an uncomplicated aneurysm. Appendectomy was performed and the abscess drained. The postoperative period passed without complications, and the patient again refused surgery for the aneurysm, which due to its anatomical characteristics was not a candidate for standard endovascular treatment. Conclusions In light of this experience, we review the literature about the relationship between abdominal aortic aneurysm and acute appendicitis.

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A féregnyúlvány diverticulosisa, diverticulitise. Esetismertetés és irodalmi áttekintés

Orvosi Hetilap ◽

10.1556/650.2018.31010 ◽

2018 ◽

Vol 159 (19) ◽

pp. 768-772

Author(s):

Tamás Vass ◽

Attila Zaránd ◽

Dániel Horányi ◽

László Harsányi

Keyword(s):

Acute Appendicitis ◽

Preoperative Diagnosis ◽

Histopathological Examination ◽

Iliac Fossa ◽

Abdominal Ultrasound ◽

Vermiform Appendix ◽

Review Of The Literature ◽

Rebound Tenderness ◽

History Of ◽

The Right

Abstract: Diverticulitis of the vermiform appendix is a rare disease with clinical features often similar to conventional acute appendicitis. The importance of appendiceal diverticulosis is the fact that it can lead to an early and a higher incidence of perforation and therefore a higher mortality rate, in contrast to acute appendicitis alone. In this study we present the clinicopathology, diagnosis and therapy of the disease with a review of the literature. A 65-year-old woman presented to the emergency department with a 48-hour history of intermittent pain in the right iliac fossa. Abdominal ultrasound raised the possibility of acute appendicitis but because of the relative asymptomatic state of the patient, the lack of fever and rebound tenderness we started observation. After 2 days with episodic abdominal pain, the patient was taken to the operating theatre for laparoscopic exploration. Intraoperatively, multiple diverticula were noted on the appendix and appendectomy was performed. Histopathological examination revealed diverticulosis and inflammation of the appendiceal wall. Due to the possible complications, the difficult preoperative diagnosis and its frequent association with appendiceal neoplasm, appendiceal diverticulosis requires special attention. For asymptomatic cases, incidentally diagnosed intraoperatively or discovered by radiology prophylactic appendectomy is recommended. Orv Hetil. 2018; 159(19): 768–772.

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Torsion of caecal appendices epiploicae: mimicking acute appendicitis

International Surgery Journal ◽

10.18203/2349-2902.isj20202858 ◽

2020 ◽

Vol 7 (7) ◽

pp. 2407

Author(s):

A. P. Roshini ◽

Dattaprasad Samant ◽

F. P. Noronha

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Iliac Fossa ◽

Lower Abdominal Pain ◽

Free Fluid ◽

Normal Appendix ◽

Menstrual Cycles ◽

Rebound Tenderness ◽

Appendices Epiploicae ◽

The Right

Acute appendicitis is a common cause for pain in the right iliac fossa, which requires urgent surgical intervention. However, at the time of surgery, if the appendix is normal, the surgeon has to search for other causes of acute abdominal pain including rare etiologies, such as torsion of appendices epiploicae and subsequently its gangrene. We report the case of a 45 years old female who presented with right lower abdominal pain, rebound tenderness and guarding in right iliac fosse, with regular menstrual cycles and no urinary complaints. Investigation revealed leucocytosis and ultra-sonography abdomen was suggestive of an inflamed appendix in the right iliac fossa with free fluid. Intra-operatively, we found a normal appendix with gangrene of the appendices epiploicae which had undergone torsion. She underwent excision off appendices epiploicae with appendicectomy with uneventful post-operative period. Histopathology of the appendices was suggestive of congestion. Preoperative diagnosis of this condition is rarely made.

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Subhepatic appendix: an ectopic topography not to be disregarded: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02883-6 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Abdoul Kadir Ibrahim Mamadou ◽

Souleymane Mounkaila ◽

Nouhou Hama Aghali ◽

Mahaman Laouali Harouna Amadou ◽

Ousseini Adakal

Keyword(s):

Elderly Patient ◽

Peptic Ulcer ◽

Abdominal Pain ◽

Case Report ◽

Surgical Intervention ◽

Quadrant Pain ◽

Case Presentation ◽

Perforated Appendix ◽

History Of ◽

The Right

Abstract Introduction Subhepatic appendix is most often due to an anomaly of rotation of the primary intestine occurring during embryogenesis. This ectopic topography associated with advanced age can be a serious diagnosis problem at the stage of appendicitis or appendicular peritonitis. Case presentation We report the case of a 60-year-old melanoderm man, with a history of urinary pathology and peptic ulcer, referred from a health district for abdominal pain of the right hypochondrium evolving for about 5 days, secondarily generalized, in whom we suspected peritonitis, the etiology of which remains to be determined. During the surgical intervention, after preoperative resuscitations measures, a phlegmonous perforated appendix was found under the liver. No postoperative complication was noted, and he was discharged home 8 days after his operation. Conclusion Subhepatic appendicular peritonitis occurring in an elderly patient poses enormous diagnostic problems. When faced with right upper quadrant pain, considering acute ectopic appendicitis would significantly reduce complications.

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Reduction en masse of inguinal hernia after self-reduction: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02845-y ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Khosrow Najjari ◽

Hossein zabihi Mahmoudabadi ◽

Seyed Zeynab Seyedjavadeyn ◽

Reza Hajebi

Keyword(s):

Case Report ◽

Inguinal Hernia ◽

Ct Scan ◽

Lower Quadrant ◽

Case Presentation ◽

Delay In Diagnosis ◽

Patient Reported ◽

History Of ◽

Old Persian ◽

The Right

Abstract Background Reduction en mass (REM) is one of the rare complications of inguinal hernia reduction. Although REM can be detected on the basis of specific computed tomography (CT) scan findings, many radiologists are not familiar with its radiological appearance because of the scarcity of this complication, which may cause a delay in diagnosis. Case presentation The patient reported in this article was a 50-year-old Persian man with a history of inguinal hernia, who had been referred with the periumbilical pain that radiated to the right lower quadrant and developed following hernia replacement by the patient himself. REM diagnosis was based on clinical examination and CT scan findings, and surgical treatment was performed by the Lichtenstein repair and mesh implantation. Conclusions Although REM usually occurs after reduction with compression in the inguinal hernia, this unique case report highlighted the possibility of REM after self-reduction. Surgeons and radiologists should consider REM in patients with a history of inguinal hernia presenting with intestinal obstruction symptoms, even without any apparent signs of hernia in the physical examination.

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