Sadeghi Nima, McDermott Jamie, Kermanshahi Nazanin, Anasi Ayman, Ahmed Imtiaz
Medicine, Midwestern University Arizona College of Osteopathic Medicine, Glendale, USA.
Radiology, Tempe St. Luke's Hospital, Tempe, USA.
Cureus. 2024 Nov 8;16(11):e73305. doi: 10.7759/cureus.73305. eCollection 2024 Nov.
Inguinal hernias are the most prevalent type of abdominal wall hernia. While many cases are uncomplicated, some variant forms can pose a heightened risk of severe complications. We report the case of a 46-year-old male who arrived at the emergency department with a two-day history of diffuse abdominal pain, with an otherwise negative review of systems, an unremarkable medical and surgical history, and normal laboratory results. The physical examination revealed a palpable, non-reducible mass in the right groin, raising suspicion of an inguinal hernia. A CT scan of the abdomen and pelvis was conducted, confirming Amyand's hernia, characterized by the presence of the vermiform appendix within the hernia sac in the dilated right inguinal canal. Amyand's hernia is a rare and clinically challenging condition to diagnose because its symptoms are nonspecific and often resemble those of other inguinal hernias. Delayed diagnosis can heighten the risk of complications, including inflammation, infection, perforation, and acute appendicitis. Mortality rates for Amyand's hernias have been reported to be between 14% and 30%, primarily due to complications associated with infections, especially peritoneal sepsis. Prompt diagnosis and treatment of Amyand's hernia, usually involving surgical hernia repair and an appendectomy if appendicitis is present, are highly effective in preventing potentially life-threatening complications. Despite their rarity, the difficult nature of the diagnosis and the associated high mortality rate underscore the importance of considering Amyand's hernia as a serious differential diagnosis.
腹股沟疝是腹壁疝最常见的类型。虽然许多病例并不复杂,但一些变异形式可能会带来严重并发症的高风险。我们报告一例46岁男性病例,该患者因弥漫性腹痛两天而到急诊科就诊,系统回顾其他方面均为阴性,既往内科和外科病史无异常,实验室检查结果正常。体格检查发现右侧腹股沟有一个可触及的、不能回纳的肿块,怀疑为腹股沟疝。进行了腹部和盆腔CT扫描,证实为阿米亚德疝,其特征是在扩张的右侧腹股沟管疝囊内存在阑尾。阿米亚德疝是一种罕见且临床诊断具有挑战性的疾病,因为其症状不具特异性,且常与其他腹股沟疝相似。诊断延迟会增加并发症的风险,包括炎症、感染、穿孔和急性阑尾炎。据报道,阿米亚德疝的死亡率在14%至30%之间,主要是由于与感染相关的并发症,尤其是腹膜败血症。对阿米亚德疝进行及时诊断和治疗,通常包括手术疝修补术,如果存在阑尾炎则进行阑尾切除术,对于预防潜在的危及生命的并发症非常有效。尽管它们很罕见,但诊断的困难性质和相关的高死亡率凸显了将阿米亚德疝作为严重鉴别诊断考虑的重要性。