Upadrasta Vasishtha Avadhani, Koul Avinash, Chauhan Vikrant Singh
Dept. of General Surgery, Fortis Hospital, Sector 62, Noida, UP, 201309, India.
J Med Case Rep. 2025 Jan 13;19(1):15. doi: 10.1186/s13256-024-05015-y.
Amyand's hernia, an uncommon condition characterized by the presence of the appendix within an inguinal hernial sac (< 1% incidence), poses diagnostic and therapeutic challenges. Often it is an intraoperative finding, with almost no clinical symptoms.
This is a case of an Indian male in his early 80 years, diagnosed with bilateral direct inguinal hernias, one of which contained a noninflamed appendix. Given the thinned out abdominal wall, dense adhesions, and no demarcation between layers, the decision to proceed with a modified Bassini's with Lichtenstein mesh repair without appendectomy, guided by intraoperative findings and the Losanoff-Basson Classification, reflecting the complex interplay between individual patient factors and intraoperative considerations. The patient did well during his postoperative stay and was in good health on a 45 day follow-up, with no complaints suggestive of recurrence or obstruction.
This case underscores the importance of tailored management strategies and highlights, especially in cases where recurrence and postoperative wall integrity are in question, the ongoing need for research to refine treatment guidelines for Amyand's hernia, especially in cases of appendicitis not diagnosed preoperatively.
艾米安德疝是一种罕见疾病，其特征为腹股沟疝囊内存在阑尾（发病率<1%），给诊断和治疗带来挑战。它通常是术中发现的，几乎没有临床症状。
这是一名80岁出头的印度男性患者，被诊断为双侧腹股沟直疝，其中一侧疝囊内含有未发炎的阑尾。鉴于腹壁变薄、粘连致密且各层之间无明显界限，根据术中发现以及洛萨诺夫 - 巴森分类法，决定在不进行阑尾切除术的情况下采用改良巴锡尼氏法加用利希滕斯坦补片修补术，这反映了个体患者因素与术中考虑因素之间的复杂相互作用。患者术后恢复良好，45天随访时身体健康，无复发或梗阻相关主诉。
该病例强调了个体化管理策略的重要性，并突出表明，尤其是在复发和术后腹壁完整性存疑的情况下，持续需要开展研究以完善艾米安德疝的治疗指南，特别是在术前未诊断出阑尾炎的病例中。
