Saim Hani Atiqah, Chik Ian, Jaafar Fahrol Fahmy, Zuhdi Zamri, Jarmin Razman, Azman Azlanudin
Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Ann Coloproctol. 2023 Apr;39(2):183-187. doi: 10.3393/ac.2021.00430.0061. Epub 2021 Oct 18.
An Amyand's hernia is characterised as the presence of the appendix in an inguinal hernial sac. During laparoscopic cholecystectomy for gallbladder polyps, an incidental Amyand's hernia was discovered in a 75-year-old female patient. On examination, the hernia contained an appendiceal mucocele but no evidence of perforation. An open appendicectomy with tension-free mesh repair was performed for the hernia. The histopathological report of the appendix was a low-grade appendiceal mucinous neoplasm (LAMN), an entity that is just as rare as an Amyand's hernia. The patient had the right inguinal swelling for over 10 years but it was thought to be an inguinal intramuscular cyst as reported on a previous abdominal ultrasound. Mucocele of the appendix may have a benign or malignant appendiceal progress, leading to individualised diagnosis and treatment. We review an Amyand's hernia with LAMN and discuss the asymptomatic tendency yet malignant potential of appendiceal mucoceles along with treatment strategies.
艾米安德疝的特征是腹股沟疝囊内存在阑尾。在为一名75岁女性患者进行胆囊息肉的腹腔镜胆囊切除术时,偶然发现了一例艾米安德疝。检查发现,疝内容物为阑尾黏液囊肿,但无穿孔迹象。对该疝进行了开放阑尾切除术并采用无张力补片修补。阑尾的组织病理学报告显示为低级别阑尾黏液性肿瘤(LAMN),这一实体与艾米安德疝一样罕见。患者右侧腹股沟肿胀超过10年,但根据之前的腹部超声检查报告,曾被认为是腹股沟肌内囊肿。阑尾黏液囊肿可能有良性或恶性的阑尾进展,需要个体化诊断和治疗。我们回顾了一例合并LAMN的艾米安德疝,并讨论了阑尾黏液囊肿的无症状倾向及其恶性潜能以及治疗策略。