A RARE VARIATION OF AMYAND?S HERNIA: GANGRENEOUS APPENDICITIS IN AN INCARCERATED INGUINAL HERNIA SAC

Incarcerated inguinal hernia is a common diagnosis in patients presenting a painful and nonreducible groin mass. Although the diagnosis is usually made by physical examination, the content of the hernia sac and the extent of the surgical operation may vary and can require multimodal imaging integration (e.g., ultrasonography, computed tomography); the usual finding is a segment of small bowel and, less commonly, large bowel. We present an extremely rare case of a sigmoid cancer incarcerated in a left inguinal hernia and infiltrating the spermatic cord. The patient underwent whole-body computed tomography (CT) with contrast agent injection for staging, followed by a left hemicolectomy paralleled by a unilateral orchiectomy.

Download Full-text

Incarcerated Appendix Epiploica in Inguinal Hernia Sac: Treatment with Laparoscopic TAPP Approach—Report of a Rare Case

Case Reports in Surgery ◽

10.1155/2020/4178523 ◽

2020 ◽

Vol 2020 ◽

pp. 1-3

Author(s):

Abdullah Yildiz

Keyword(s):

Emergency Department ◽

Inguinal Hernia ◽

Sigmoid Colon ◽

Rare Case ◽

Internal Inguinal Ring ◽

Hernia Sac ◽

Incarcerated Inguinal Hernia ◽

Transabdominal Preperitoneal ◽

Direct Hernia ◽

Mesh Hernioplasty

Appendix epiploica (AE) in an incarcerated inguinal hernia sac is very rare. We herein report the case of a 57-year-old man admitted to the emergency department with complaints of nausea, swelling, and pain in the left inguinal area. He was diagnosed with left incarcerated inguinal hernia and treated laparoscopically with transabdominal preperitoneal (TAPP) mesh hernioplasty. During the operation, AE, lodged in the direct hernia sac, was seen to originate from the sigmoid colon. The narrow internal inguinal ring was incised at the 2 o’clock position using a monopolar hook, and the hypertrophic AE was reduced to the abdomen and resected. The patient was discharged uneventfully on the second postoperative day.

Download Full-text

A Case of Incarcerated Inguinal Hernia Causing Sigmoid Colon Perforation in the Hernia Sac

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) ◽

10.3919/jjsa.81.101 ◽

2020 ◽

Vol 81 (1) ◽

pp. 101-105

Author(s):

Akira SEKIMOTO ◽

Shinichiro MIYAZAKI ◽

Tadataka HAYASHI ◽

Yoshiro NISHIWAKI

Keyword(s):

Inguinal Hernia ◽

Sigmoid Colon ◽

Colon Perforation ◽

Hernia Sac ◽

Incarcerated Inguinal Hernia ◽

Sigmoid Colon Perforation

Download Full-text

Extrapelvic endometrioma presenting as acute incarcerated right inguinal hernia in a postpartum patient

BMJ Case Reports ◽

10.1136/bcr-2019-231213 ◽

2019 ◽

Vol 12 (9) ◽

pp. e231213 ◽

Cited By ~ 1

Author(s):

Erum Azhar ◽

Salma M Mohammadi ◽

Fauzan M Ahmed ◽

Abdul Waheed

Keyword(s):

Inguinal Hernia ◽

Lower Quadrant ◽

Hernia Sac ◽

Incarcerated Inguinal Hernia ◽

History Of ◽

Chocolate Cyst ◽

Atypical Presentations ◽

Immediate Surgery ◽

The Right ◽

Right Lower Quadrant

A 33-year-old postpartum patient, who had an uncomplicated repeat caesarean section 4 weeks prior, presented with a 2-day history of acute right lower quadrant, incisional and groin pain. She was found to have a palpable tender lump in the right groin. A CT scan with contrast identified fluid along the anterior abdominal wall of the right lower quadrant (inguinal region) measuring about 1.7 cm, a preliminary diagnosis of an incarcerated inguinal hernia was made and the patient underwent immediate surgery. The hernia sac was dissected free and had chocolate cyst that was confirmed to be endometrioma on histopathology. The hernia defect was repaired. Postoperative, the patient did well and was discharged home. We emphasise to consider this differential diagnosis of extrapelvic inguinal endometrioma in reproductive-aged women with or without history of endometriosis especially in a post-caesarean patient who has atypical presentations.

Download Full-text

Hernia Sac Laparoscopy under Spinal Anesthesia for Evaluation of Reduced Incarcerated Inguinal Hernia

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-006-0057-z ◽

2007 ◽

Vol 11 (8) ◽

pp. 1081-1082 ◽

Cited By ~ 5

Author(s):

Kazuaki Takabe

Keyword(s):

Inguinal Hernia ◽

Spinal Anesthesia ◽

Hernia Sac ◽

Incarcerated Inguinal Hernia

Download Full-text

Sigmoid Colon Cancer Penetrating an Incarcerated Inguinal Hernia Sac—A Case Report—

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) ◽

10.3919/jjsa.77.1500 ◽

2016 ◽

Vol 77 (6) ◽

pp. 1500-1504

Author(s):

Jun YAMAMOTO ◽

Hiroaki SUGIURA ◽

Masuyo MIYAKE ◽

Kotaro NAGAMINE ◽

Kunio KAMEDA ◽

...

Keyword(s):

Colon Cancer ◽

Case Report ◽

Inguinal Hernia ◽

Sigmoid Colon ◽

Sigmoid Colon Cancer ◽

Hernia Sac ◽

Incarcerated Inguinal Hernia

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

Case of anisakiasis presenting as an Amyand hernia

BMJ Case Reports ◽

10.1136/bcr-2020-234822 ◽

2020 ◽

Vol 13 (7) ◽

pp. e234822

Author(s):

William Hope ◽

Faye Smith-Chakmakova ◽

Justin Snyder

Keyword(s):

Inguinal Hernia ◽

Signs And Symptoms ◽

Preoperative Imaging ◽

Medical Work ◽

Hernia Sac ◽

Incarcerated Inguinal Hernia ◽

Amyand Hernia ◽

Low Threshold ◽

Patient’S History ◽

Work Up

This is a case of a 31-year-old male patient who presented with signs and symptoms of an incarcerated inguinal hernia. The patient’s preoperative imaging showed a tubular structure in the inguinal canal and given the patient’s history at presentation, there was a concern for herniation of the appendix, known as an Amyand hernia. On laparoscopy, there was no evidence of appendiceal involvement and a standard open inguinal hernia was completed. On the final pathology of the hernia sac, roundworms were identified with Y-shaped lateral cords suggesting infection by Anisakis spp. On a further interview with the patient, he revealed that he had recently travelled to Alaska and had consumed raw salmon on a fishing trip. This case demonstrates the importance of a thorough social and travel history. One should also have a low threshold to broaden the differential diagnosis when medical work-up deviates from the standard course.

Download Full-text

Amyand’s Hernia: A Challenging Diagnosis

Open Journal of Gastroenterology and Hepatology ◽

10.28933/ojgh-2021-10-3105 ◽

2021 ◽

pp. 57

Author(s):

Keyword(s):

Emergency Department ◽

Inguinal Hernia ◽

Surgical Repair ◽

Incidental Finding ◽

Amyand’S Hernia ◽

Open Approach ◽

Hernia Sac ◽

Incarcerated Inguinal Hernia ◽

Amyand Hernia ◽

Outpatient Settings

Background: Hernia repair surgery is a procedure frequently performed today, both in elective or outpatient settings as in an emergency context. Hernia is defined as a condition in which part of an organ or its fascia protruded through the wall of the cavity containing it. Quite often in the emergency department incarcerated hernias are found, and in most cases, the content of the hernia sac is the omentum or small intestine. In very rare instances, the appendix can be found inside the hernia sac. When the appendix is found in the hernia sac it is called an “Amyand Hernia”, regardless if it is inflamed or not, with the incidence of appendicitis in an inguinal hernia being 0.07-0.13%. Preoperative diagnosis of an Amyand hernia is a clinical and often a Radiological challenge, being in many cases misdiagnosed as an incarcerated inguinal hernia. Usually, the diagnosis of Amyand’s hernia is an incidental finding during surgical repair of an inguinal hernia. There is still no real consensus on the ideal surgical treatment approach for this pathology. Clinical Case: A 72-year-old man, with a known reducible right inguinal hernia awaiting surgical repair presented to the Emergency Department with acute abdominal pain, nausea, vomiting and a painful right groin mass. He was diagnosed with an incarcerated right inguinal hernia and taken to the operating room for emergency surgery. An open approach was performed with a transverse right inguinal incision and the inflamed appendix was identified inside the inguinal sac. The patient was submitted to an appendectomy and subsequently, using the Bassini technique, had the incarcerated inguinal hernia corrected. Conclusion: Preoperative clinical and imaging diagnosis of amyand´s hernia is rare and difficult. More prospective studies should be carried out in order to standardize the treatment of this pathology. The diagnosis of Amyand´s hernia should be in the surgeon’s mind especially in the case of a strangulated inguinal hernia, as shown in this case.

Download Full-text

An Appendiceal Carcinoid Tumor within an Amyand’s Hernia Mimicking an Incarcerated Inguinal Hernia

Case Reports in Surgery ◽

10.1155/2017/5932657 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Gregorios Christodoulidis ◽

Konstantinos Perivoliotis ◽

Alexandros Diamantis ◽

Dionysios Dimas ◽

Michael Spyridakis ◽

...

Keyword(s):

Inguinal Hernia ◽

Carcinoid Tumor ◽

Laboratory Tests ◽

Emergency Operation ◽

Right Hemicolectomy ◽

Amyand’S Hernia ◽

Hernia Sac ◽

Incarcerated Inguinal Hernia ◽

Appendiceal Carcinoid ◽

Serum Crp

Introduction.We report the case of an appendiceal carcinoid tumor within an Amyand’s hernia, presenting as an incarcerated right inguinal hernia.Presentation of Case.A 52-year-old male presented in the emergency department due to a persistent right inguinal pain. Clinical examination revealed a tender right groin mass. Laboratory tests revealed leukocytosis and an increased serum CRP. Under the diagnosis of an incarcerated right inguinal hernia, an emergency operation was taken. Intraoperatively, an inflamed appendix and a part of the cecum were found in the hernia sac. The operation was completed with an appendectomy and a modified Bassini hernia repair. Histological examination revealed a carcinoid tumor, resulting in the performance of a right hemicolectomy.Discussion.Amyand’s hernia is estimated to account for 0.4% to 0.6% of all inguinal hernias. Coexistence of an Amyand’s hernia and a neoplasia is quite rare. Carcinoids are the most frequent tumors found in the appendix, with the size of the primary tumor to be considered the most important prognostic factor and the basis upon which the operative plan is decided.Conclusion.A malignancy of the appendix should always be in the differential diagnosis of a right inguinal mass, in order to provide optimum surgical treatment.

Download Full-text