Amyand's hernia

Amyand's hernia
SpecialtyGastroenterology
SymptomsEpigastric or periumbilical pain, regional tenderness in the right lower quadrant, and an inguinal or inguino-scrotal tender irreducible mass.[1]
Named afterClaudius Amyand

Amyand's hernia is a rare form of an inguinal hernia (less than 1% of inguinal hernias)[2] which occurs when the appendix is included in the hernial sac and becomes incarcerated. The condition is an eponymous disease named after a French surgeon, Claudius Amyand (1660–1740),[3] who performed the first successful appendectomy in 1735.[4]

Most of the cases are diagnosed intraoperatively and a preoperative diagnosis is rarely made in such cases. Management should be individualized according to appendix's inflammation stage, presence of abdominal sepsis, and comorbidity factors. The decision should be based on factors such as the patient's age, the size and anatomy of the appendix, and in case of appendicitis, standard appendectomy and herniorrhaphy without a mesh should be the standard of care.[5]

Amyand's hernia is commonly misdiagnosed as an ordinary incarcerated hernia. Symptoms mimicking appendicitis may occur. Treatment consists of a combination of appendectomy and hernia repair.[6] The inflammatory status of the appendix determines the type of hernia repair and the surgical approach. Incidental appendicectomy in the case of a normal appendix is not favoured.[7]

  1. ^ Cite error: The named reference Tubbs 2014 pp. 140–146 was invoked but never defined (see the help page).
  2. ^ Cankorkmaz, Levent; Ozer, Hatice; Guney, Cengiz; Atalar, Mehmet H.; Arslan, Mehmet S.; Koyluoglu, Gokhan (January 2010). "Amyand's hernia in the children: A single center experience". Surgery. 147 (1): 140–143. doi:10.1016/j.surg.2009.09.038. PMID 19910011.
  3. ^ Amyand's Hernia at Who Named It?
  4. ^ Amyand, Claudius (1735). "Of an inguinal rupture, with a pin in the appendix caeci, incrusted with stone; and some observations on wounds in the guts". Philosophical Transactions of the Royal Society of London. 39 (443): 329–336. doi:10.1098/rstl.1735.0071.
  5. ^ Faiz N, Ahmad N, Singh R. Case series on different presentations of Amyand's hernia. Arch Int Surg [serial online] 2016 [cited 2017 Mar 18];6:176-9. Available from: http://www.archintsurg.org/text.asp?2016/6/3/176/202373
  6. ^ Hutchinson, R (February 1993). "Amyand's Hernia". Journal of the Royal Society of Medicine. 86 (2): 104–105. PMC 1293861. PMID 8433290.
  7. ^ Sharma, H., Gupta, A., Shekhawat, N.S. et al. Hernia (2007) 11: 31. https://doi.org/10.1007/s10029-006-0153-8.