Das Anirban, Pandurangappa Vikas, Tanwar Sushant, Mohan Sajith K, Naik Harish
Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND.
Cureus. 2023 Apr 8;15(4):e37313. doi: 10.7759/cureus.37313. eCollection 2023 Apr.
Amyand's hernia is a rare type of hernia where the appendix is found to be the content of the inguinal hernial sac. It is most often diagnosed intraoperatively wherein the appendix may be found healthy, incarcerated, inflamed, or perforated. Claudius Amyand performed a successful appendectomy on a patient with an appendix noted in the inguinal canal and this condition was hence named after him. The incidence of Amyand's hernia is rare in inguinal hernia patients. There are no defined guidelines for the management of Amyand's hernia but adequate resuscitation followed by immediate appendectomy is widely followed. Here is a case report of a 60-year-old male presenting to the Emergency Department with an irreducible right-side inguinal hernia with features of small bowel obstruction. On exploration, Amyand's hernia was identified with appendicular tip perforation due to an impacted fishbone with pyoperitoneum. Appendectomy was done through midline laparotomy with impacted fishbone removal from the hernial sac with tissue repair of the hernia. There are as such no reported cases of fishbone-induced appendicular perforation in an Amyand's hernia in the available literature. After the exploration, we found the management of the case challenging regarding the closure of the hernia.
艾米安德疝是一种罕见的疝，其腹股沟疝囊内容物为阑尾。它最常在术中被诊断出来，术中可能发现阑尾是健康的、嵌顿的、发炎的或穿孔的。克劳迪乌斯·艾米安德为一名腹股沟管内发现阑尾的患者成功实施了阑尾切除术，因此这种病症以他的名字命名。艾米安德疝在腹股沟疝患者中发病率很低。目前尚无针对艾米安德疝治疗的明确指南，但普遍的做法是先进行充分的复苏，然后立即进行阑尾切除术。以下是一例60岁男性患者的病例报告，该患者因右侧腹股沟疝无法回纳并伴有小肠梗阻症状就诊于急诊科。术中发现为艾米安德疝，阑尾尖端因鱼骨嵌顿穿孔并伴有脓性腹膜炎。通过正中剖腹术进行阑尾切除术，从疝囊中取出嵌顿的鱼骨，并对疝进行组织修复。在现有文献中，尚无鱼骨导致艾米安德疝阑尾穿孔的病例报道。探查后，我们发现该病例在疝修补方面具有挑战性。
