Amyand's hernia
Amyand's hernia | |
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Named after | Claudius Amyand |
Amyand's hernia is a rare form of an
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]
Signs and symptoms
An appendix trapped in an inguinal hernia can become inflamed, infected, or perforated. Although incarcerated, an appendix may appear to be completely healthy.[1]
Common complaints include
Diagnosis
Amyand's hernia is rarely diagnosed preoperatively and the diagnosis typically occurs during surgery. Amyand's hernia is not always associated with physical, laboratory, or imaging examinations.[8] Even though it is practically impossible clinically, preoperative diagnosis of Amyand's hernia is possible with CT and ultrasound technology. The appendix can be seen directly inside the inguinal canal using CT. Amyand's hernia was also discovered by chance during a barium enema.[9]
Differential diagnosis includes Inguinal
Treatment
Amyand's hernia is traditionally treated with appendectomy, abscess drainage if present, hernia reduction, and hernioplasty through the same incision. In cases of inflammation, peritonitis, or cecum incarceration, an ischemic right hemicolectomy may be required.[9]
Epidemiology
Amyand's hernia is found in about 1% of all inguinal hernias, and appendicitis caused by an Amyand's hernia accounts for 0.1% of all appendicitis cases. According to recent research, its true prevalence is even lower, ranging between 0.4% and 0.6% of all inguinal hernias. Amyand's hernia is about three times more common in children, and its prevalence can reach up to 1%.[9]
History
Creese proposed the term "Amyand hernia" in 1953, followed by Hiatt and Hiatt in 1988, and Hutchinson in 1993, in honor of
See also
References
- ^ PMID 24473371.
- PMID 19910011.
- Who Named It?
- .
- ^ 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
- PMID 8433290.
- ^ Sharma, H., Gupta, A., Shekhawat, N.S. et al. Hernia (2007) 11: 31. https://doi.org/10.1007/s10029-006-0153-8.
- PMID 34301235.
- ^ PMID 24280148. Retrieved November 14, 2023.
- ^ PMID 22879848.
Further reading
- Garagliano, Joseph M; Jaramillo, Joshua D; Kopecky, Kimberly E; Knowlton, Lisa Marie (2020). "Amyand hernia: considerations for operative approach and surgical repair". Trauma Surgery & Acute Care Open. 5 (1). BMJ: 000466. PMID 32420454.