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Query: UMLS:C0085693 (acute appendicitis)
 3,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute appendicitis in a hernia sac occurs exceptionally. An 80-year-old male patient underwent emergency surgery for an incarcerated right inguinal hernia found to contain a gangrenous appendix. His brief improvement after an emergency herniotomy with appendectomy was followed by intestinal obstruction caused by advanced colon cancer. The unique features and individualized management of the four published types of Amyand hernia are reviewed. Rather than simply being an anatomical curiosity, Amyand hernias require individualized attention to decide how to manage both the appendix and the hernia. Clinical scrutiny, a high index of suspicion for surgical comorbidities, and a common sense approach may improve outcomes.
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PMID:Amyand hernia: what lies beneath--a proposed classification scheme to determine management. 1818 92

A case of acute appendicitis within an inguinal hernia known as Amyand's hernia, is presented. Multidetector CT investigation with multiplanar reconstruction (MPR) is an important tool to make an early and correct diagnosis avoiding complications in this very rare event.
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PMID:Amyand's hernia: inguinal hernia with acute appendicitis. 1837 69

Amyand's hernia is defined as an inguinal hernia within the hernial sac containing the appendix. It is a rare disease, reported in 1% of cases of inguinal hernia repair. The appendix can be complicated by acute appendicitis in 0.13% of cases. This disease is often very difficult to diagnose, and most of the time it can be confused with an incarcerated or strangulated inguinal hernia. Often, it requires an emergent surgical treatment. This article describes the case of a 82-year-old female who was admitted for an intestinal obstruction and a bulge in the right inguinal region. An abdominal computed tomography scan showed dilated small bowel loops with multiple air/liquid levels and one loop herniating into the right inguinal canal. The patient underwent a laparotomy that showed the presence of an acute appendicitis and a necrotized ileal loop protruding into the right inguinal canal. The patient underwent an appendectomy and small bowel resection and she was discharged on postoperative day 10. Amyand's hernia can be a challenge for the surgeon. Its treatment depends on the grade of inflammation of the appendix. In fact, it can range from the simple repair of the abdominal defect with a prosthetic mesh, to appendectomy, small bowel resection and repair of the abdominal wall defect without a mesh.
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PMID:[A rare presentation of Amyand's hernia. Case report and review of the literature]. 1842 48

Amyand hernia, named for the first person to describe an inguinal hernia containing the vermiform appendix, is an uncommon variant of an inguinal hernia. Presence of the appendix in the sac complicates the management of inguinal hernias. The appendix may be more prone to rupture when contained within a hernia sac, and herniation of an inflamed appendix into the scrotum can mimic an acute scrotum. A 50-year-old man presented with right lower quadrant abdominal pain associated with chills and anorexia. Physical examination revealed right lower quadrant tenderness and a right inguinal mass without associated skin changes. Laboratories were normal. A plain abdominal computed tomography scan for acute appendicitis showed an indirect right inguinal hernia with the appendix contained within the sac, which was incarcerated. Surgical consultation was obtained. The patient taken to the operating room, and his appendix was removed. The hernia was coincidentally repaired, and the patient was discharged soon thereafter. In cases suggestive of acute appendicitis complicating an inguinal hernia, the diagnosis of this unusual variant must be considered.
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PMID:Amyand hernia: a case of an unusual inguinal herniace. 1853 18

Few cases have been reported in the literature on acute appendicitis located in the hernial sac. Information scantiness is determined by rarity of pathology and difficulties in diagnosis. Incidence rate of the condition is 0.4-0.6% of cases. The acute appendicitis is frequently located in the sac of right inguinal hernia or femoral hernia sac. The studies of three cases are presented in the article. In 1994-2007 at The Surgical Department of Phyphia Clinical Hospital (Tbilisi, Georgia) there have been performed 1064 hernia repairs. Entrapped hernia was diagnosed in 189 patients of whom three patients (from 70 to 84 years old, of whom two male and one female)--with acute perforated appendicitis located in hernia sac. In two cases perforated appendix was within the right inguinal hernia area and in one case--gangrenous appendix was located in femoral hernia sac. All three patients were operated upon routinely as for entrapped hernias. Laparoscopic inguinal herniotomy with removal of gangrenous-perforated appendix was performed in two patients. Herniotomy and laparotomy was performed in one patient. In spite of old age and heavy concomitant diseases postoperative period passed uneventfully. The patients were discharged from the Clinic under further ambulatory observation.
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PMID:[The presense of acute appendicitis in the sac of inguinal hernia: case study]. 1856 31

Albeit very uncommon, the hernia sac may contain unusual structures such as vermiform appendix, acute appendicitis, ovary, fallopian tube and, urinary bladder. Most of the cases of hernia containing ovary and fallopian tubes were reported to be found in children and, often accompanied with other congenital anomalies of genital tract. We present the first case of sliding inguinal hernia containing right ovary and fallopian tube and a right paraovarian cyst in 80-year-old, multiparous patient without any associated genital anomaly. The hernia was repaired with plication darn, while the paraovarian cyst was excised and adnexa were preserved. It is of utmost importance to keep in mind that the hernia sac may contain almost any abdominal organ, and surgical dissection should be carried out accordingly. Pathophysiologically, the ovary might be simply pulled along with a sliding paraovarian cyst or the paraovarian cyst might be accompanying the maldescended ovary. There seems to be a need for clinical and experimental studies to further explain the mechanisms that apply to the pathogenesis of sliding inguinal hernias.
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PMID:A right sliding indirect inguinal hernia containing paraovarian cyst, fallopian tube, and ovary: a case report. 1883 35

Acute appendicitis in an incarcerated inguinal hernia is termed an Amyand's hernia. This is an extremely rare condition. It is often misdiagnosed as a strangulated inguinal hernia. The clinical presentation varies, depending on the extent of inflammation in the hernia sac and the presence or absence of peritoneal contamination. We report a case of Amyand's hernia in a 2 year old boy who presented with shock. The basic principle in our management was to stick to the principles of resuscitation and stabilisation of the patient completely before surgery, which lead to a very successful outcome. Emphasis is given to the rarity of the disease and to the review of the literature.
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PMID:Amyand's hernia. 1980 55

Laparoscopic inguinal herniorraphy via a transabdominal preperitoneal (TAPP) approach using Polypropylene Mesh (Mesh) and staples is an accepted technique. Mesh induces a localised inflammatory response that may extend to, and involve, adjacent abdominal and pelvic viscera such as the appendix. We present an interesting case of suspected Mesh-induced appendicitis treated successfully with laparoscopic appendicectomy, without Mesh removal, in an elderly gentleman who presented with symptoms and signs of acute appendicitis 18 months after laparoscopic inguinal hernia repair. Possible mechanisms for Mesh-induced appendicitis are briefly discussed.
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PMID:Laparoscopic appendicectomy for suspected mesh-induced appendicitis after laparoscopic transabdominal preperitoneal polypropylene mesh inguinal herniorraphy. 2058 90

Laparoscopic surgery has an increasing use in today's world of general surgery, especially in the treatment of diseases such as acute appendicitis, acute cholecystitis, diverticulitis, lysis of adhesions in the setting of small bowel obstruction, incarcerated or strangulated inguinal hernia, and perforated peptic ulcer disease. The aim of this paper is to discuss the diagnosis and management of each disease while placing emphasis on the role of laparoscopy in its treatment.
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PMID:Laparoscopic repair of acute surgical diseases in the 21st century. 2066 17

The Amyand hernia is an uncommon variant of the inguinal hernia, rarely recognised before the surgical treatment because of the confusion with a strangled hernia. In spite of this, the clinical presentation seems to follow a well determined pathway, so it is possible to state that the uncorrect diagnosis is to be attributed to the ignorance of this variant of hernia. We present two consecutive case reports of acute appendicitis founded in an inguinal hernia sac. The clinical presentation depended on the inflammation extension inside the hernia sac and the presence or not of peritoneal contamination. The patients were admitted for a painful pseudotumor in the inguinal region with irreducibility, mimicking strangled inguinal hernia with acute inflammatory syndrome. Intraoperatively we have found a hernia sac with a phlegmonous/gangrenous appendix inside. Appendectomy was performed, followed by hernioplasty (retrofunicular technique) without prosthetic material). The operation followings were favorable. We conclude that amyand hernia must be considered as differential diagnosis of apparently strangled inguinal hernias. Technical precautions and antibioprophylaxy applied during surgery may prevent septic complications after hernioplasty. The hernia repair must be performed without prosthetic material and using exclusively resorbable sutures.
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PMID:[Amyand hernia--a rare anatomic and clinical entity diagnosed intraoperatively]. 2124 5


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