Munasinghe B M, Jayasuriya N J A S S, Pathirana W P N K, Paranamanna R V, Jayalath M K D H V, Karunarathna M W I D
Anesthesiology, Base Hospital, Thambuththegama, LKA.
Surgery, Base Hospital, Thambuththegama, LKA.
Cureus. 2025 Jan 2;17(1):e76828. doi: 10.7759/cureus.76828. eCollection 2025 Jan.
Amyand's hernia is a rare form of inguinal hernia, where the appendix is located within the inguinal sac. A 66-year-old male presented with an obstructed, incarcerated right inguinal hernia. He underwent an emergency herniotomy under spinal anesthesia. Intraoperatively, the hernia sac contained a viable small bowel and part of the appendix. As the appendix appeared mildly inflamed, an appendicectomy was performed, and a synthetic mesh repair was done. He received a postoperative course of antibiotics and was discharged home on day 3 after an uneventful recovery. Histology of the appendix revealed a fecolith in the absence of acute inflammation. He did not have any procedure-related complications on follow-up. Preoperative diagnosis of Amyand's hernia is a challenge due to nonspecific symptoms and rarity. Lasanoff and Basson classify Amyand's hernia and provide surgical guidance for its management. Our case belonged to the type 2 category. Management of Amyand's hernia needs an individually tailored approach rather than strict adherence to conventional guidelines. The presence of an appendicular fecolith in the absence of inflammation provides an interesting area to explore in an Amyand's hernia.
艾米安德疝是一种罕见的腹股沟疝，阑尾位于腹股沟疝囊内。一名66岁男性因右侧腹股沟疝梗阻、嵌顿前来就诊。他在脊髓麻醉下接受了急诊疝修补术。术中，疝囊内包含一段存活的小肠和部分阑尾。由于阑尾看起来有轻度炎症，遂进行了阑尾切除术，并进行了合成补片修补。他接受了术后抗生素治疗，恢复顺利，术后第3天出院。阑尾组织学检查显示存在粪石，但无急性炎症。随访期间他没有出现任何与手术相关的并发症。由于症状不具特异性且罕见，艾米安德疝的术前诊断具有挑战性。拉萨诺夫和巴森对艾米安德疝进行了分类，并为其治疗提供了手术指导。我们的病例属于2型。艾米安德疝的治疗需要个体化的方法，而不是严格遵循传统指南。在无炎症情况下阑尾粪石的存在为艾米安德疝的研究提供了一个有趣的领域。
