Department of pediatric surgery, University Clinical Centre of Kosova, 10 000 Prishtina, Kosova.
World J Emerg Surg. 2010 May 19;5:14. doi: 10.1186/1749-7922-5-14.
Presence of vermiform appendix (non-inflamed or inflamed) in inguinal hernia is called Amyand's hernia in honor to surgeon C. Amyand who published the first case of perforated appendicitis within inguinal hernia in a boy caused by ingested pin. This presentation of foreign body Amyand's hernia appendicitis is very rare, and here we present such a case.
A 6-year-old boy, white Kosovar ethnicity, presented with right groin pain, swelling and redness. Two days before admission the patient was injured by football during a children game in the right lower abdomen and the next day he complained of pain in the right inguinal area.On admission patient had a painful non-reducible mass in the right inguinal region and cellulitis. Plain abdominal x-ray showed no fluid-air levels, but a metallic foreign body (pin) under right superior pubic ramus was apparent. With preoperative diagnosis of suspect incarcerated inguinal hernia with cellulitis the patient was operated on under general anaesthesia in December 2, 2006. Intraoperatively we found the inflamed vermiform appendix perforated by a pin in the hernial sac. Appendectomy and herniotomy were performed. The wound was primary closed, without any post-operative complications and follow up for the patient is three years long.
Foreign body (pin) Amyand's hernia appendicitis seems to be extremely rare, maybe once in a century (Amyand 1735, Hall 1886, and our case in 2006). In patients with clinical signs of incarcerated inguinal hernia, with locally inflammatory signs, but without signs of intestinal obstruction Amyand's hernia appendicitis in differential diagnosis must be considered. In our case, it is possible that the injury during the football game might have induced perforation of the vermiform appendix with the foreign body in it.
在腹股沟疝中存在（非炎症或炎症）的阑尾称为艾米安德疝，以纪念首次发表腹股沟疝中穿孔性阑尾炎病例的外科医生 C.艾米安德，该病例是由吞下的别针引起的。这种外来体艾米安德疝阑尾炎的表现非常罕见，在此我们报告这样一个病例。
一名 6 岁男孩，白人科索沃族裔，因右腹股沟疼痛、肿胀和发红而就诊。在入院前两天，患者在儿童足球比赛中右下腹部受伤，第二天他抱怨右腹股沟区域疼痛。入院时，患者右腹股沟区有疼痛不可复性肿块和蜂窝织炎。腹部平片未见液-气平面，但右耻骨上支下有一个金属异物（别针）。术前诊断为可疑嵌顿性腹股沟疝伴蜂窝织炎，患儿于 2006 年 12 月 2 日在全身麻醉下接受手术。术中发现疝囊内穿孔的炎症性阑尾被别针穿孔。进行了阑尾切除术和疝切开术。伤口一期缝合，无术后并发症，患者随访 3 年。
异物（别针）艾米安德疝阑尾炎似乎非常罕见，也许每世纪仅出现一次（艾米安德 1735 年，霍尔 1886 年，以及我们 2006 年的病例）。在具有嵌顿性腹股沟疝临床体征、局部炎症体征但无肠梗阻体征的患者中，必须考虑到艾米安德疝阑尾炎作为鉴别诊断。在我们的病例中，足球比赛中的受伤可能导致阑尾穿孔，其中有异物。
