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We encountered a rare case of appendiceal carcinoma associated with Amyand's hernia, which was difficult to diagnose preoperatively. A 74-year-old man presented to our hospital with right lower abdominal pain. A hard mass was palpable in the right lower abdomen, and blood tests showed a slightly elevated inflammatory response. Computed tomography revealed a 7 × 5 cm mass with indistinct borders and heterogeneous internal density extending from the cecum to the right lower abdominal wall. We diagnosed appendiceal abscess, however, percutaneous biopsy which was performed for differential diagnosis with appendiceal carcinoma showed no malignancy. Thereafter, the patient was followed up. Two months later, a blood test showed insignificant changes in the inflammatory response and a high serum carcinoembryonic antigen level (48.6 ng/mL). An ultrasound showed a mass contiguous to the appendix, extending to the abdominal wall, with abundant blood flow signals. Fluorodeoxyglucose-positron emission tomography showed a high accumulation of fluorodeoxyglucose in the mass. Four months after the initial visit, the patient had an open ileocecal resection combined with an abdominal wall resection based on the preoperative diagnosis of appendiceal carcinoma invading the abdominal wall. During laparotomy, an enlarged appendix tip extended from the internal inguinal ring outside the inferior epigastric artery to the abdominal wall. Histopathological examination of the appendiceal tumor revealed well-differentiated adenocarcinoma, T4b (abdominal wall), N0, Ly0, and V0. When a right lower abdominal mass extends from the cecum to the abdominal wall, appendiceal tumors associated with Amyand's hernia should be considered. [ABSTRACT FROM AUTHOR]

Amyand's hernia is a rare type of inguinal hernia characterized by the presence of the vermiform appendix within the hernia sac. It was named after Claudius Amyand who performed the world's first successful appendectomy on an 11-year-old boy with a right inguinal hernia in 1735 and discovered a herniated appendix during surgery.This condition warrants urgent surgical treatment, with the type of surgical intervention depending on the appendix's condition. However, the nonspecific clinical presentation often complicates the preoperative diagnosis, emphasizing the critical role of imaging in surgical planning.Herein, we present the case of a 74-year-old male who presented with fever, inguinal swelling, and discomfort. Clinical suspicion of inguinal and scrotal inflammation prompted us to perform a prompt CT scan. This radiological evaluation led to a preoperative diagnosis of a Type 3 Amyand's hernia.This case highlights the significance of CT scans in the accurate and timely diagnosis of Amyand's hernia. Distinguishing between various types of Amyand's hernia is pivotal as it profoundly influences surgical decision-making and postoperative outcomes. By sharing this case, we contribute to current knowledge about Amyand's hernia, increase clinical awareness of the condition, and emphasize the crucial role of imaging in its management.

Amyand’s hernia is a rare disorder characterized by the presence of the vermiform appendix within an inguinal hernia. It is predominantly found in the pediatric age group, and its occurrence in adulthood is rare. Hence, a systematic analysis of twenty-six case reports of Amyand’s hernia published in the peer-reviewed literature in the year 2023 is presented with emphasis on variables including age of the patient, gender, clinical presentation, side of the inguinal hernia, imaging modalities used for evaluation, achievement of preoperative diagnosis or otherwise, classification, appendix management, hernia management, surgical approach, and outcomes. [ABSTRACT FROM AUTHOR]

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Amyand’s hernia is a rare disorder characterized by the presence of the vermiform appendix within an inguinal hernia. It is predominantly found in the pediatric age group, and its occurrence in adulthood is rare. Hence, a systematic analysis of twenty-six case reports of Amyand’s hernia published in the peer-reviewed literature in the year 2023 is presented with emphasis on variables including age of the patient, gender, clinical presentation, side of the inguinal hernia, imaging modalities used for evaluation, achievement of preoperative diagnosis or otherwise, classification, appendix management, hernia management, surgical approach, and outcomes.

Abstract Background Amyand’s hernia is characterized as an inguinal hernia in which the hernia sac contains the appendix. It is highly atypical for the appendix structure to be contained within the hernia sac. Patients with Amyand’s hernia are typically asymptomatic and are frequently identified intraoperatively. Rarely seen in medical literature, this case report details the incidental finding of Amyand’s hernia and the successful preoperative diagnosis. Case presentation A 61-year-old male presented to the urology clinic for his urinary tract complaint. An incidental finding of Amyand’s hernia was found in a non-contrast computerized tomography of the abdomen. Following the evaluation of computed tomography scan images showing the condition of the appendix and radiological findings regarding Amyand’s hernia, the surgeon planned the patient’s herniorrhaphy with mesh. Conclusions Amyand’s hernia is often overlooked; therefore, radiologic examination can help to confirm this diagnosis.

Abstract Background Amyand’s hernia (AH) is an appendix (with or without acute inflammation) trapped within an inguinal hernia. Most AH with acute appendicitis had a preexisting appendix within the hernia sac. We herein report a variant of AH that has never been described before. An inflamed appendix that was managed conservatively was found to have migrated and trapped in the sac of a previously unrecognized right inguinal hernia 6 weeks after the index admission, resulting in a secondary Amyand’s hernia. Case presentation A 25-year-old healthy Taiwanese woman had persistent right lower abdominal pain for 1 week and was diagnosed with perforated appendicitis with a localized abscess by abdominal computed tomography (CT). No inguinal hernia was noted at that time. Although the inflamed appendix along with the abscess was deeply surrounded by bowel loops so that percutaneous drainage was not feasible, it was treated successfully with antibiotics. However, she was rehospitalized 6 weeks later for having a painful right inguinal bulging mass for a week. Abdominal CT revealed an inflamed appendix with abscess formation in an indirect inguinal hernia raising the question of a Amyand’s hernia with a perforated appendicitis. Via a typical inguinal herniorrhaphy incision, surgical exploration confirmed the diagnosis, and it was managed by opening the hernial sac to drain the abscess and reducing the appendix into the peritoneal cavity, followed by conventional tissue-based herniorrhaphy and a laparoscopic appendectomy. She was then discharged uneventfully and remained well for 11 months. Conclusions Unlike the traditional definition of Amyand’s hernia, where the appendix is initially in the hernia sac, the current case demonstrated that Amyand’s hernia could be a type of delayed presentation following initial medical treatment of acute appendicitis. However, it can still be managed successfully by a conventional tissue-based herniorrhaphy followed by laparoscopic appendectomy.

Abstract Incarceration of the appendix within a femoral hernia is a rare condition of abdominal wall hernia about 0.1 to 0.5% in reported femoral hernia [1]. We report a case of a 56-year-old female whose appendix was trapped in the right femoral canal. There are few reports in the literature on entrapment of the appendix within a femoral hernia. The management of this condition includes antibiotics, drainage appendectomy, hernioplasty and mesh repair.

Background: Amyand's hernia (AH) is an appendix (with or without acute inflammation) trapped within an inguinal hernia. Most AH with acute appendicitis had a preexisting appendix within the hernia sac. We herein report a variant of AH that has never been described before. An inflamed appendix that was managed conservatively was found to have migrated and trapped in the sac of a previously unrecognized right inguinal hernia 6 weeks after the index admission, resulting in a secondary Amyand's hernia. Case presentation: A 25-year-old healthy Taiwanese woman had persistent right lower abdominal pain for 1 week and was diagnosed with perforated appendicitis with a localized abscess by abdominal computed tomography (CT). No inguinal hernia was noted at that time. Although the inflamed appendix along with the abscess was deeply surrounded by bowel loops so that percutaneous drainage was not feasible, it was treated successfully with antibiotics. However, she was rehospitalized 6 weeks later for having a painful right inguinal bulging mass for a week. Abdominal CT revealed an inflamed appendix with abscess formation in an indirect inguinal hernia raising the question of a Amyand's hernia with a perforated appendicitis. Via a typical inguinal herniorrhaphy incision, surgical exploration confirmed the diagnosis, and it was managed by opening the hernial sac to drain the abscess and reducing the appendix into the peritoneal cavity, followed by conventional tissue-based herniorrhaphy and a laparoscopic appendectomy. She was then discharged uneventfully and remained well for 11 months. Conclusions: Unlike the traditional definition of Amyand's hernia, where the appendix is initially in the hernia sac, the current case demonstrated that Amyand's hernia could be a type of delayed presentation following initial medical treatment of acute appendicitis. However, it can still be managed successfully by a conventional tissue-based herniorrhaphy followed by laparoscopic appendectomy. [ABSTRACT FROM AUTHOR]

Incarceration of the appendix within a femoral hernia is a rare condition of abdominal wall hernia about 0.1 to 0.5% in reported femoral hernia [1]. We report a case of a 56-year-old female whose appendix was trapped in the right femoral canal. There are few reports in the literature on entrapment of the appendix within a femoral hernia. The management of this condition includes antibiotics, drainage appendectomy, hernioplasty and mesh repair. [ABSTRACT FROM AUTHOR]

Amyand's hernia is a rare condition, in which the appendix is found in the inguinal hernia sac. Many patients remain asymptomatic and this pathological condition is most commonly diagnosed intraoperatively. We report a case of a 66-year-old male who was admitted to the hospital for an inguinal hernia repair and the presence of the appendix in the inguinal hernia sac was discovered intraoperatively. We performed a reduction of the appendix in the abdominal cavity and a hernia repair with a mesh and a plug. There are few studies in literature about the appropriate method of treatment and, because of that, the therapeutic approach remains controversial. Therefore, we also conducted a review of the literature in order to obtain some conclusions regarding the management of Amyand's hernia. [ABSTRACT FROM AUTHOR]

PURPOSE: Amyands hernia is a rare hernia defined as an inguinal hernia that contains the appendix within the hernia sac. Current treatment of Amyands hernia remains controversial. Our study retrospectively reviewed 6 cases of Amyands hernia, aiming to provide a reference for the surgical treatment of Amyands hernia. METHODS: Six patients diagnosed with Amyands hernia from September 2010 to May 2020 were retrospectively enrolled in our study. We summarized clinical data of six patients including the chief complaint, physical examinations, laboratory examinations, imaging examinations, surgical methods, and postoperative treatments and outcomes. RESULTS: The diagnosis of six cases with Amyands hernia was made during surgery. Two patients had normal appendixes whereas the remaining four patients had appendicitis. Two patients with normal appendix received tension-free mesh repair through the inguinal incision. Among those with inflamed or perforated appendixes, two received mesh repair and the other two did not. The discharge time after surgery of six patients was 9.8 ± 6.1 days. One patient suffered from a wound infection. No additional postoperative complications were detected. CONCLUSIONS: Computed tomography and ultrasonography are helpful but limited in the definite diagnosis of Amyands hernia. The presence of a normal appendix does not require to be resected, but appendicectomy is necessary if the appendix is inflamed. The treatment of Amyands hernia should be tailored based on the patients condition and the type of Amyands hernia.

Acute appendicitis is common abdominal condition in our day to day surgical practice. Classical features include periumbilical pain that migrates to the right iliac fossa, anorexia, fever, and tenderness and guarding in the right iliac fossa. However, in our present study, three atypical presentation of acute appendicitis is demonstrated in clinical practice. These three cases do not have classical features of murphy’s triad, that is, nausea, vomiting, fever, and cardinal sign of positive Mcburney’s tenderness. Our three atypical cases are: (1) A 38 year old obese male patient who presented with features of umbilical inflammation with serous discharge due to presence of acute inflamed appendix in pre-existing small umbilical hernial sac. (2) A 49-year-old male medicine seller presented right sided scrotal pain with same sided inguino-scrotal swelling for short duration due to presence of inflamed swollen tip of appendix at bottom of right hemi-scrotum in pre-existing inguinal hernia. (3) A 81-years-male gentleman presented with anorexia, weakness, abdominal fullness, and bilateral pedal edema. He did not have pain abdomen, fever, and right iliac fossa tenderness. Imaging modalities confirmed the acute appendicitis in three cases. Diagnosis of appendicitis in absence of typical features is to be made from pre-occupied knowledge and with help of imaging studies.

Introduction: Amyand's hernia (AH) is a rare type of inguinal hernia that occurs when the appendix is trapped within the hernia sac. AH accounts for approximately 1% of all inguinal hernias. However, there is currently no comprehensive review on the manifestation of AH in preterm infants. Case presentation: A male preterm infant, born at 31+5 weeks’ gestational age with a birthweight of 1040 g, presented with a right inguinal mass at 39 days of life. The inguinal mass was firm, irreducible and erythematous. The infant also exhibited symptoms of fever and poor feeding. An abdominal X-ray showed an obstructive ileus consistent with clusters of cyst-like gas bubbles suggesting pneumatosis intestinalis. Recognizing the urgent need for intervention, emergent surgery was performed. A transverse incision along the right inguinal crease. An intraoperative exploration revealed a gangrenous appendix within the hernia which indicating AH. Herniorrhaphy and appendectomy were successfully performed without any postoperative complications. Feeding was resumed 8 days after the surgery, and the infant was discharged soon with full recovery. Conclusion: AH is characterized by an irreducible inguinal mass that is predominantly found on the right side in preterm infants, especially males. In less mature infants, the manifestation of AH may be more severe. Therefore, AH should be considered in the differential diagnosis of infants with abdominal emergencies, and careful intra-operative assessment is essential. AH typically requires less complex treatment and has a favorable prognosis compared to other abdominal conditions in preterm infants.

Amyand's hernia is a rare inguinal hernia where the appendix is trapped in the hernia sac. This uncommon hernia is most often revealed as an incidental finding, and the demonstration of this disease process is variable. This case study presents a scrotal sonogram of a 48-year-old male complaining of pain and swelling, without history of trauma. Sonographic images of the right inguinal region identified Amyand's hernia that contained fat, free fluid, and the appendix. Treatment of Amyand's hernia is highly debatable, but most cases are treated based upon classification that includes the state of the appendix, the patient's age, septic state, and if any peritoneal involvement was identified. [ABSTRACT FROM AUTHOR]

Purpose: The presence of an appendix in the inguinal hernia sac is defined as Amyand's hernia (AH). This study intends to present the authors' experience in dealing with this entity and also to present a discussion on possible need of updating its definition, classification, and management. Materials and Methods: A retrospective analysis of records of all pediatric patients undergoing surgery for congenital inguinal hernia in a single unit from January 2017 to March 2021 was done. Patient's demographics, clinical presentation, preoperative investigations, peroperative findings, and postoperative outcomes were recorded and analyzed. Results: AH was found in eight patients. All were boys. The median age of presentation was 20.5 months (range 2 months to 36 months). The mean duration of symptoms was 2 days (range 2 to 4 days). All patients presented with incarcerated inguinoscrotal swelling (right sided = 5, left sided = 3); associated with pain. An abdominal radiograph and ultrasonography were done for all. All patients underwent emergency surgery. Exploration was done for all through an inguinal incision. The appendix was found inflamed for two patients, and appendectomy was done for the same. None of the patients underwent incidental appendectomy. Wound infection, secondary appendicitis, and recurrence were not seen for any of the patients. The authors have also proposed a revised definition and classification of AH. Conclusion: AH is an interesting entity and many questions like the need for incidental appendectomy remain unanswered. An updating of the definition and classification system can probably offer some solution in this regard. However, more research is warranted in this regard. [ABSTRACT FROM AUTHOR]

Amyand's hernia refers to an inguinal hernia which contained the vermiform appendix in the hernia sac. It is more commonly found on the right side in relation to anatomical location of the vermiform appendix and left - sided Amyand's hernia is very rare. Herein, we report a case of left - sided Amyand's hernia with bowel obstruction in a 1 year 4 months old boy. The left groin mass was firm and tender, with skin erythema. However, the mass could not be completed incarcerated into the abdominal cavity. His abdomen was distended with sluggish bowel sound. A diagnosis of intestinal obstruction secondary to obstructed left inguino - scrotal hernia was made, and laparotomy was performed. During laparotomy, transverse skin incision was made on the upper abdomen, and the left inguinal canal was opened in accordance with the usual inguinal hernia repair. The hernia sac contained the appendix, caecum and twisted terminal ileal loops. Small bowel resection with primary anastomosis was performed with left herniorrhaphy. Appendix was preserved due to its normal appearance. He remained well during follow up with no hernia recurrence and testicular atrophy. [ABSTRACT FROM AUTHOR]

Acute appendicitis is common abdominal condition in our day to day surgical practice. Classical features include periumbilical pain that migrates to the right iliac fossa, anorexia, fever, and tenderness and guarding in the right iliac fossa. However, in our present study, three atypical presentation of acute appendicitis is demonstrated in clinical practice. These three cases do not have classical features of murphy's triad, that is, nausea, vomiting, fever, and cardinal sign of positive Mcburney's tenderness. Our three atypical cases are: (1) A 38 year old obese male patient who presented with features of umbilical inflammation with serous discharge due to presence of acute inflamed appendix in pre-existing small umbilical hernial sac. (2) A 49-year-old male medicine seller presented right sided scrotal pain with same sided inguino-scrotal swelling for short duration due to presence of inflamed swollen tip of appendix at bottom of right hemi-scrotum in pre-existing inguinal hernia. (3) A 81-yearsmale gentleman presented with anorexia, weakness, abdominal fullness, and bilateral pedal edema. He did not have pain abdomen, fever, and right iliac fossa tenderness. Imaging modalities confirmed the acute appendicitis in three cases. Diagnosis of appendicitis in absence of typical features is to be made from pre-occupied knowledge and with help of imaging studies. [ABSTRACT FROM AUTHOR]

Background: Amyand's Hernia (AH) is a rare entity described as the presence of the vermiform appendix in an inguinal hernial sac. Though its prevalence is three times more in children than adults, owing to the presence of patent processus vaginalis, its occurrence with acute appendicitis is more uncommon in children, especially in infants. Seldom diagnosed correctly ahead of surgical exploration, it is often clinically diagnosed as an incarcerated inguinal hernia or as a case of acute scrotum. The management of such cases depends upon the per-operative findings. Case presentation: In this series, we report four cases of AH treated at King Saud Medical City Hospital Riyadh between 2018 and 2022.All the four patients were male and three of them were infants. Three patients had right sided hernia, while one had bilateral inguinal hernia. One of the patients was diagnosed with strangulated hernia and upon exploration it was AH with acute appendicitis and appendectomy was done. One child had recurrent, irreducible hernia and upon exploration, found appendix densely adherent to the hernial sac. Another patient had early suppurative inflammation at the tip, while the patient with bilateral hernias had appendix adherent to the right hernial sac. In all our cases appendectomy was performed either due to inflammation or adhesions. Conclusion: There is a rarity of this condition and few cases have been reported in the literature. Such cases need to be reported to keep the surgeons aware of this condition and its different manifestations. Herein, we aim to share our experience of four cases of AH with varied presentations and a literature review.

Amyand's hernia (AH) is an extremely rare type of inguinal hernia where the vermiform appendix is present within the inguinal hernia sac. This report documents the first known instance of AH in Sudan, highlighting its unprecedented occurrence in this region. A 2-month-old infant presented to the ER with an obstructed right-sided inguinal hernia for 6 h. During surgical repair, an inflamed appendix was found within the hernial sac. The appendix was ligated, excised, herniotomy was performed to repair the hernia, and the appendix was sent for histopathological examination. This case underscores the importance of recognizing rare presentations of common conditions in different geographical and demographic contexts. The co-occurrence of acute appendicitis and AH in infants poses a diagnostic challenge, often only detected incidentally during surgical exploration. By presenting this unique case, we aim to raise awareness about the potential for such rare hernias in pediatric populations. Early recognition and proper management are crucial for ensuring optimal patient outcomes and preventing complications associated with delayed diagnosis or treatment. • First documented case of Amyand's hernia (AH) in Sudan. • AH diagnosed in a 2-month-old infant with an obstructed right-sided inguinal hernia. • Surgical repair revealed an inflamed appendix within the hernial sac. • Case emphasizes the need for early recognition and management of rare hernias in infants. • Raises awareness of AH in pediatric populations in diverse geographic regions [ABSTRACT FROM AUTHOR]

The patient was an 11-month-old boy. He has been followed up at an outpatient clinic for inguinal hernia. He visited at our emergency room because of multiple episodes of vomiting. After receiving a diagnosis of incarcerated hernia, he underwent emergency surgery under general anesthesia. Intraoperative findings showed that not only the appendix but also the cecum, ascending colon, and end of the ileum had herniated, so we diagnosed him with expansive Amyand's hernia. None of the intestine was necrotic, and intestinal resection was not necessary, but there was significant ileocecal dilatation. Therefore, we resected the appendix and inserted a flexible catheter through the root of appendix to decompress the ileocecal lumen. If the ultrasound sonography at outpatient clinic had shown an appendix-like intestine with proper attention, we may have been able to diagnose him with expansive Amyand's hernia. It is crucial to check the diagnosis of hernia but also detailed contents of the hernia sac carefully by ultrasound sonography. If the appendix is confirmed with the intestine in the hernia sac, we should consider early elective surgery to avoid an emergency operation.

About 75% of abdominal wall hernias are inguinal hernias, with a lifetime risk of 27% for males and 3% for women. Amyand's hernia is an uncommon disorder in which an inguinal hernia sac contains a vermiform appendix. In the paediatric population and in men, it is most often observed. There have only been 228 known cases of the Amyand's hernia since Claudius Amyand's initial case was published in 1736. The clinical appearance, treatment, and complications of the illness are yet unknown because of its rarity. Although Amyand's hernia's appearance can be extremely diverse, it often manifests as an imprisoned or strangulated hernia. We describe a case that looked similar but was actually a right inguinal hernia. [ABSTRACT FROM AUTHOR]

When appendix is found in the inguinal hernia sac whether inflamed or non-inflamed then this type of inguinal hernia is called Amyand's Hernia. It is found mostly on right side in incarcerated inguinal hernia with male gender preponderance. Here we present case of 80-year-old male with incarcerated inguinal hernia and was operated in emergency operation theatre. Intraoperatively type 3 Amyand's hernia was found, operation was converted to midline laparotomy and appendectomy was performed with no mesh placement in inguinal region due pus collection in hernia sac. Amyand's hernia is rare pathology and is found intraoperatively most of the time. It should be kept in mind while operating incarcerated or strangulated inguinal hernia. CT scan may provide clear picture of pathology preoperatively. [ABSTRACT FROM AUTHOR]

Introduction: Amyand's hernia (AH) is a very rare condition and occurs when the cecal appendix is located within an inguinal hernia. Clinical case: 15-month-old male with a history of right inguinal hernia, who had been scheduled for surgical correction. He was admitted to the emergency room due to a mass in the right inguinal region associated with pain and irritability; during the physical examination, an incarcerated hernia is diagnosed because it cannot be reduced, requiring immediate surgical intervention. Regarding the surgical findings, it was confirmed that the inguinoscrotal hernia was incarcerated, identifying the terminal ileum, cecum, and cecal appendix inside. Appendectomy and high ligation of the vaginal peritoneum duct is performed. The patient progressed favorably. Conclusion: there are few published cases of incarcerated AH. We hope that this article will serve for the timely detection of similar cases to improve their prognosis. [ABSTRACT FROM AUTHOR]

Purpose: Amyand's hernia (AH) is the name given to the type of hernia in which the appendix is found in a hernial sac. We aimed to share our clinical experience with a literature review for AH., Methods: A total of 1,774 inguinal hernias and 13 AH cases were repaired in our clinic between 2009 and 2020. In addition, detailed clinical features about AH were extracted by including unpublished data of 165 cases, which were gathered from the extensive literature on childhood AHs using PubMed, Web of Science, and Cochrane databases., Results: The rate of AH was 0.73% in all inguinal hernias; this rate was 8.6% for incarcerated hernias. The average age was 5.74 ± 7.27 months for AH. Our AH cases were seen in males and on the right side. AH is seen in 97.3% of males according to a review of 69 articles. The average age was 16.78 ± 30.46 months. One hundred sixty-five of the AH cases were on the right (88.7%). The main symptoms were swelling or redness in the inguinal region, pain, fever, and vomiting, along with patients presenting septic or with stercoral fistula., Conclusion: If the appendix is normal and easily reduced, high ligation is sufficient. In cases where reduction is difficult and/or the appendix is inflamed, appendectomy and hospitalization should be performed., Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported., (Copyright © 2024, the Korean Surgical Society.)

Amyand's hernia is a rare clinical condition containing appendix as the content of hernia. The incidence of this type of hernia is rare; the appendix may become incarcerated within the sac and can lead to strangulation or perforation. This case report highlights the clinical presentation, diagnosis, and management of an Amyand's hernia in a strangulated masquerade in a 75-year-old male. It signifies the importance of early recognition and prompt surgical intervention to counteract potential complications associated with this condition., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Rout et al.)

Numerous types of hernias have been reported in the literature. A unique and uncommon type of hernia known as an Amyand's hernia occurs when the inguinal sac contains the vermiform appendix. Due to its rarity, it is usually difficult to diagnose and often goes unreported. However, when it goes unnoticed and untreated, it can lead to complications such as strangulation and perforation. This is where medical imaging plays a pivotal role. This case study aims to provide an overview of Amyand's hernia while highlighting the vital role that imaging plays in diagnosing the condition, identifying any associated problems, characterizing the pathology, and classifying the hernia. This supports grading the severity and determining the appropriate course of management., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pimpri, Pune, India, issued approval NA. Our institute does not require ethical committee approval for case reports. No additional tests have been done solely for the purpose of this case report. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Khaladkar et al.)

We present a challenging case of a loss of domain (LOD) inguinoscrotal hernia in a 77-year-old high-risk patient, successfully managed with the complementary preoperative use of progressive pneumoperitoneum (PPP) and botulinum toxin A (BTA) without complications. Giant inguinoscrotal and LOD hernias, particularly in multimorbid patients, are highly complex and require meticulous preoperative preparation. In this case, PPP was performed with ambient air and a gradual increase in insufflation volume, while BTA was injected at three points on each side, with a total dose of 300 IU. This approach facilitated a complication-free increase in abdominal cavity volume and the repositioning of chronically eventrated abdominal contents. The technique proved safe, feasible, and effective, contributing to atraumatic adhesiolysis, reduced operative time, and avoidance of more invasive surgical methods. A Shouldice pure tissue repair was performed, successfully avoiding the need for prosthetic materials., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Baco et al.)

An 82-year-old man presented to our emergency department with a bulge in the right groin and worsening pain that had been present for one week. An abdominal computed tomography scan revealed fluid collection within a right inguinal hernia and a thickened appendix within the hernia sac. The patient underwent an emergency laparoscopic appendectomy under a diagnosis of Amyand's hernia with peri-appendicular abscess. During surgery, the incarcerated appendix was pulled back into the abdominal cavity from the hernia sac, and the perforated appendix was resected. For drainage of the abscess, a drain tube was laparoscopically placed into the hernia sac through the internal inguinal ring. Considering the risk of mesh infection and wound infection, the patient underwent appendectomy alone but not hernia repair at this time. Two months later, Lichtenstein repair using mesh was performed as a second-stage procedure. For Amyand's hernia with abscess, this type of two-stage strategy may avoid the surgical site infection, and the use of mesh in a second procedure would minimize the possibility of hernia recurrence, unlike previously reported cases treated by concomitant appendectomy and hernia repair., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. The Ethics Committee of Juntendo University Nerima Hospital issued approval S24-05. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Chiba et al.)

De Garengeot hernia, a rare clinical entity characterized by the presence of the appendix within a femoral hernia sac, is a challenging condition often requiring prompt surgical intervention. Fewer than 100 cases have been reported in the literature containing appendicitis in de Garengeot hernia. We present a case of a 40-year-old female with a preoperatively diagnosed De Garengeot hernia with appendicitis. The patient presented with a painful and irreducible right groin swelling, and imaging revealed a femoral hernia containing an inflamed appendix. Urgent surgical intervention was undertaken, involving right femoral hernia repair and appendectomy. The surgical procedure, utilizing the infra-inguinal approach, proceeded uneventfully, with the patient recovering well postoperatively. De Garengeot hernia is a rare clinical presentation with no established treatment guidelines. Surgical management typically involves hernia repair and appendectomy, with the choice of repair method dependent on intraoperative findings. The use of prosthetic mesh in contaminated fields remains controversial, with considerations for infection risk and patient outcomes. Early diagnosis and appropriate surgical intervention are essential in managing De Garengeot hernia to prevent complications and ensure favourable patient outcomes. This case underscores the importance of recognizing and effectively treating this uncommon surgical condition., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alkhalifa et al.)

We encountered a rare case of appendiceal carcinoma associated with Amyand's hernia, which was difficult to diagnose preoperatively. A 74-year-old man presented to our hospital with right lower abdominal pain. A hard mass was palpable in the right lower abdomen, and blood tests showed a slightly elevated inflammatory response. Computed tomography revealed a 7 × 5 cm mass with indistinct borders and heterogeneous internal density extending from the cecum to the right lower abdominal wall. We diagnosed appendiceal abscess, however, percutaneous biopsy which was performed for differential diagnosis with appendiceal carcinoma showed no malignancy. Thereafter, the patient was followed up. Two months later, a blood test showed insignificant changes in the inflammatory response and a high serum carcinoembryonic antigen level (48.6 ng/mL). An ultrasound showed a mass contiguous to the appendix, extending to the abdominal wall, with abundant blood flow signals. Fluorodeoxyglucose-positron emission tomography showed a high accumulation of fluorodeoxyglucose in the mass. Four months after the initial visit, the patient had an open ileocecal resection combined with an abdominal wall resection based on the preoperative diagnosis of appendiceal carcinoma invading the abdominal wall. During laparotomy, an enlarged appendix tip extended from the internal inguinal ring outside the inferior epigastric artery to the abdominal wall. Histopathological examination of the appendiceal tumor revealed well-differentiated adenocarcinoma, T4b (abdominal wall), N0, Ly0, and V0. When a right lower abdominal mass extends from the cecum to the abdominal wall, appendiceal tumors associated with Amyand's hernia should be considered., Competing Interests: The authors have no competing interests to declare.

Abstract: Amyand’s hernia is described in the inguinal hernia sac as being the presence of an appendix vermiformis. It is a rare condition the incidence is about 1 per cent of all inguinal hernias. It is often diagnosed incidentally during inguinal hernia surgery. The main treatment method of Amyand’s hernia is surgery. We report a case of 63 years old man who presented with right inguinal groin bulge for 1 month with the previous repaired right inguinal hernia 5 years ago. On clinical examination revealed a 6 cmx8 cm firm, nontender, irreponible mass in the right inguinal region. He was diagnosed as right sided irreponible inguinal hernia. He was undergoing the elective surgery. Intra-operative, the hernia sac was laterally found in the inferior epigastric vessels and separated from sperm cord to deep inguinal ring. The hernia sac was opened. A non-inflamed appendix was seen. Appendectomy was performed, and the hernia was repaired by Halsted’s repair. Amyand’s hernia is a rare condition. The correct diagnosis is usually made intraoperative. Keywords: Amyand’s hernia, appendectomy, hernia repair, inguinal hernia.

Objectives: Amyand's hernia is a rare clinical entity, in which the sac of an inguinal hernia contains the appendix. Its incidence is less than 1% of all inguinal hernia cases. Clinical presentation is not specific and can mislead clinical suspicion towards inguinal hernia incarceration. Different classifications have been proposed, with significant importance for the surgical management plan. The main factors to take into consideration include hernia sac content and macroscopic appearance of the appendix, intra-abdominal inflammation, the possibility of hernia recurrence, and patient's general situation and comorbidities. Materials and methods: A 60-year-old male patient with previous history of tension-free right inguinal hernia repair with mesh and cholelithiasis presented to the Emergency Department complaining of acute abdominal pain localized at the right lumbar and right iliac region and a right groin easily reducible mass. The patient had an abdominal CT performed 48 hours ago that revealed cholelithiasis and a recurrent right inguinal hernia containing the appendix. Because of the consistent pain in the right abdomen despite the easily reducible hernia, a high suspicion of a coexisting pathology was raised and a new abdominal CT scan with intravenous and per os contrast agent was ordered. The latter showed an Amyand's hernia and cholelithiasis, but also detected lithiasis of the right ureter with upstream dilatation as the main cause of abdominal pain. Results: The patient was subsequently treated with ureteral stent placement and the following day laparoscopic hernia repair with a transabdominal preperitoneal (TAPP) approach and cholecystectomy were performed. The patient was discharged from hospital on the second postoperative day without complications. Conclusions: Surgeons should be aware of different types of Amyand's hernia and have to include this entity in the differential diagnosis of right iliac fossa abdominal pain combined with a groin mass to avoid intraoperative complications and suboptimal management. It is equally important, though, to exclude other causes of abdominal pain. This case report reviews a rare entity of right inguinal hernia recurrence presenting as Amyand's hernia during the investigation of right abdominal and iliac fossa pain, that was finally attributed to ureteric colic. Special attention should be given to the thorough investigation of abdominal pain causes. [ABSTRACT FROM AUTHOR]

The Amyand hernia was described by Claudius Amyand in 1735 and is currently considered a rare entity that occurs in 1 % of all inguinal hernias in adults. This pathology consists of the finding of a rare presentation of hernias, where the cecal appendix is located within the inguinal hernial sac, without inflammatory characteristics in most cases. Evidently, a key concept associated with the hernia in question is acute appendicitis or also known as the most frequent surgical abdominal pathology predominantly in young people with a lifetime incidence of 7 %, presenting in patients over 60 years of age in a 5-10 % of cases. In the present review, we report the case of a male in the ninth decade of life who comes to a hospital with a symptomatic inguinal hernia, with signs of incarceration and associated intestinal obstruction, with intraoperative finding of Amyand hernia type 3 in the Losanoff and Basson classification, constituting a rare case of incarcerated Amyand hernia. [ABSTRACT FROM AUTHOR]

Abstract Purpose Amyand’s hernia is a rare hernia defined as an inguinal hernia that contains the appendix within the hernia sac. Current treatment of Amyand’s hernia remains controversial. Our study retrospectively reviewed 6 cases of Amyand’s hernia, aiming to provide a reference for the surgical treatment of Amyand's hernia. Methods Six patients diagnosed with Amyand’s hernia from September 2010 to May 2020 were retrospectively enrolled in our study. We summarized clinical data of six patients including the chief complaint, physical examinations, laboratory examinations, imaging examinations, surgical methods, and postoperative treatments and outcomes. Results The diagnosis of six cases with Amyand’s hernia was made during surgery. Two patients had normal appendixes whereas the remaining four patients had appendicitis. Two patients with normal appendix received tension-free mesh repair through the inguinal incision. Among those with inflamed or perforated appendixes, two received mesh repair and the other two did not. The discharge time after surgery of six patients was 9.8 ± 6.1 days. One patient suffered from a wound infection. No additional postoperative complications were detected. Conclusions Computed tomography and ultrasonography are helpful but limited in the definite diagnosis of Amyand’s hernia. The presence of a normal appendix does not require to be resected, but appendicectomy is necessary if the appendix is inflamed. The treatment of Amyand's hernia should be tailored based on the patient's condition and the type of Amyand's hernia.

Amyand's hernia is a rare inguinal hernia containing the appendix presenting mainly in male adults. The clinical presentation is usually without symptoms, however an inflammation can occur leading to strangulation, necrosis or rupture of the appendix. Differential diagnosis may be difficult including orchitis, testicular torsion, inflammation of the ovaries and bowel inflammation.We present a case of a 61 years old, male patient who was presented with persistent right abdominal pain. There was no medical history of previous hospitalization or surgery of the abdomen. Laboratory tests and radiological investigation with plain radiographs and ultrasound were not clear. A CT scan with contrast imaging was performed to reveal the diagnosis.Amyand's hernia is difficult to be revealed and a high index of suspicion is needed in order to promptly diagnose the hernia and proceed to the appropriate treatment. CT scan is critical contributing to the accurate depiction and to the classification of the hernia.

Abstract Background Amyand’s hernia was an unusual condition defined by the presence of an appendix located in the inguinal hernia sac. Its prevalence was 1% of all inguinal hernia in children. The clinical manifestation of Amyand’s hernia was depending on hernia’s stage, an incarcerated hernia will present with an inguinal mass following by pain and motility disorder. It could lead to abdominal distention in the late stage. The common location of Amyand’s hernia was on the right side, the left side was uncommon. Early feeding on infants could provoke symptoms of bowel obstruction (SBO). More than 76% of infants in Java, Indonesia was given banana as solid food in infants before six months old. There is a correlation between the early banana diet and SBO. Amyand’s hernia could present as morbidity of early banana diet. Case presentation We describe a case of two months old infant present with an incarcerated left inguinal hernia and history of early banana diet that performed herniotomy procedure. During the operation, we found left-side incarcerated Amyand’s hernia with appendicitis, excoriation caecum, and sticky banana mass. Conclusion This case suggest the possibility of early feeding of banana diet may provoke incarceration of an inguinal hernia and if the incarcerated hernia content contains the appendix, then an Amyand's hernia.

9 children aged 4 to 14 years underwent a right-sided inguinal hernia repair, at the same time, a vermiform appendix was found in the hernial sac. All patients were hospitalized with a diagnosis of «Congenital right-sided inguinoscrotal hernia», bilateral hernias were not observed. Objectively, there were all signs of the disease, all hernias were reducible. The presence of the appendix in the hernial sac before the operation was not diagnosed either clinically or by ultrasound. The contents of the hernial sac had a thickened and long vermiform appendix, a greater omentum, and in two cases – a cecum of the type of sliding hernia. The children were operated on under general anesthesia: appendectomy and plastic surgery of posterior wall of inguinal canal were performed. No complications were observed in the postoperative period.

Amyand's hernia with concurrent appendicitis is rare, with a reported incidence of 0.13 % of all inguinal hernias. This condition is challenging to diagnose and manage and no optimal treatment has been established. A 71-year-old man presented with an acutely painful, tender, and irreducible right inguinal hernia. He had a history of a right inguinal hernia for several months and had undergone open left inguinal hernia repair. The patient had no other medical comorbidities. Blood test results were nonspecific, with a C-reactive protein of 90 mg/L. Ultrasound scan suggested a strangulated right inguinal hernia. Laparoscopy revealed an Amyand's hernia with concurrent appendicitis and a pus-filled right inguinal hernia sac. The patient underwent laparoscopic appendicectomy, followed by staged laparoscopic transabdominal preperitoneal right inguinal hernia repair with mesh after eight weeks to reduce mesh infection. Histopathological examination confirmed acute uncomplicated appendicitis without perforation or malignancy. The patient had an unremarkable post-operative recovery. This case highlights the diagnostic challenges associated with Amyand's hernia and concurrent appendicitis. Laparoscopy provides both diagnostic and therapeutic opportunities. In this case, laparoscopic mesh herniorrhaphy was delayed and staged until local hernia sac inflammation resolved following appendicectomy. Surgeons should have an index of suspicion for Amyand's hernia given the heterogeneity of presentations. A case-by-case approach is required to prevent post-operative complications and determine the safe timing of definitive hernia repair when the inguinal hernial sac is inflamed. Further research is required to provide surgeons with evidence-based approaches for this unique condition. • Amyand's hernia and concurrent appendicitis present diagnostic challenges. • Surgeons should consider Amyand's hernia when patients have acute groin lumps. • Laparoscopy can offer both diagnostic and therapeutic benefits. • Hernia repair after appendicectomy should be personalized. • It should consider hernia sac inflammation and mesh infection risk. [ABSTRACT FROM AUTHOR]

The aim of this case report is to present an uncommon disease, Amyand’s hernia. It is an inguinal hernia containing the appendix in the hernial sac. The authors describe this condition analysing a clinical case and reporting a literal review which points out preoperative and intraoperative management.

Aim: Amyand's hernia is detected in 0.42%-1% of children with inguinal hernia (IH) and is quite difficult to diagnose prior to surgery. There is no consensus on its treatment. Materials and Methods: The records of patients who underwent IH repair and were diagnosed with Amyand's hernia between 2001 and 2019 were retrospectively analysed in terms of age, gender, complaints at presentation, side of IH, treatment methods (with appendectomy or reduction of appendix), complications, duration of hospital stay and follow-up. Results: In total, 3,577 patients (male/female: 3,045/532) who underwent surgery for IH and 1,898 patients who underwent appendectomy were analysed. Cases with Amyand's hernia (n=47, male/female: 41/6) accounted for 1.31%, 1.4% and 0.31% of all IH, incarcerated/strangulated hernia and appendectomy cases, respectively. The median age was 3 months. In one case, the appendix was located within the left hernial sac. One patient presented with a complaint of recurrent abscess in the right inguinal region. In all cases, the diagnosis was made intra-operatively based on identification. In 23.4% of the cases with Amyand's hernia, appendectomy was performed. In 46 of the 47 cases diagnosed with Amyand's hernia, inguinal transverse incision and high ligation procedures were performed. Acute appendicitis did not develop during follow-up in cases without appendectomy. Conclusion: Because the appendix plays an active role in the immune system, especially during childhood, and is used in some pathologic cases as luminal supportive tissue, we believe that appendectomy should not be performed if there are no signs of inflammation and the appendix can be reducted into the abdomen. [ABSTRACT FROM AUTHOR]

Abstract Background Amyand’s hernia (AH) is defined as protrusion of the vermiform appendix within the sac of the inguinal hernia and usually misdiagnosed as obstructed hernia. It is more common in pediatric patients but there are controversies about dealing with the normally looking appendix in AH. The aim of this study is to present our experience in the management of AH and highlights the difference in dealing with normally looking appendix between pediatric and adult patients. Patients’ demographics, intraoperative, and postoperative outcome were reported and analyzed. Results This is a retrospective analysis of 12 pediatric patients aged between 15 days and 5 years presented with AH and operated in tertiary referral hospital over 10 years. This study included 10 males and 2 females. The median age at the operation was 7 months. Eleven patients were operated using conventional technique, and only one patient was operated using laparoscopy. In 11 patients, the appendix was looking normal and was reduced without appendectomy, and the hernia was repaired. Appendectomy was done in one patient presented with AH containing inflamed appendix. The postoperative course was uneventful in all cases. Conclusions There is a difference in the management of pediatric and adult patients presenting with AH, and appendectomy is not mandatory in normally looking appendix in pediatric patients.

Amyand's hernia is defined as the presence of the appendix within an inguinal hernia sac, which is often associated with appendicitis. The association of an Amyand's hernia with an appendicular tumor has been reported in very few cases. This case report presents a 67-year-old female patient who came to the emergency department with symptoms indicative of a complicated inguinal hernia. Following surgical treatment, the diagnosis of Amyand's hernia with cecal perforation associated with an appendicular tumor was established in the context of a previous laparoscopic femoral hernia repair. The combination of these conditions has not been previously reported. The presentation of this case provides data on the clinical presentation, diagnosis, and treatment of this rare pathology that requires a high clinical suspicion to achieve a preoperative diagnosis., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Navarro-Castañeda et al.)

Amyand's hernia is a rare variant of inguinal hernia characterized by the presence of the vermiform appendix within the hernia sac. It represents a unique diagnostic and management challenge for surgeons due to its low incidence and varied clinical presentations. Here, we present a case of a 45-year-old man with a one-year history of right inguinoscrotal swelling, diagnosed as a right indirect inguinal hernia. Preoperative imaging revealed the presence of omentum within the hernia sac. Intraoperatively, both the omentum and the vermiform appendix were found within the sac without evidence of inflammation. The patient underwent successful Lichtenstein meshplasty without appendicectomy. This case highlights the importance of considering Amyand's hernia in the differential diagnosis of inguinal hernias and the significance of intraoperative findings in guiding surgical management. Further studies and case reports are needed to enhance our understanding of this rare clinical entity and optimize patient outcomes., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Inamdar et al.)

Introduction: Amyand's hernia, a rare condition where the appendix becomes lodged in the inguinal canal, poses diagnostic challenges due to its varied clinical presentations and lack of distinctive radiological features. This case underscores the importance of early detection and comprehensive diagnostic evaluation., Case Presentation: A 30-year-old male presented with a 2-year history of right inguinoscrotal swelling, culminating in agonizing symptoms and irreducible masses over the inguinoscrotal area. Despite the absence of significant medical history, diagnostic imaging confirmed a complete right inguinoscrotal hernia and bilateral hydrocele with internal echoes., Clinical Discussion: The case illustrates the difficulties in preoperative diagnosis of Amyand's hernia, emphasizing the reliance on imaging modalities and clinical assessment. Successful surgical intervention involving appendectomy and hernioplasty highlights the necessity for prompt diagnosis and management., Conclusion: This case exemplifies the challenges and complexities associated with Amyand's hernia, emphasizing the importance of early recognition and comprehensive surgical planning. Moving forward, increased clinical vigilance and awareness are essential to ensure optimal patient outcomes in cases of inguinoscrotal pathology., Competing Interests: The authors declare no conflicts of interest relevant to this article. No financial or nonfinancial interests have influenced the development of this work.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)