Amyand’s hernia with gangrenous perforated appendicitis and diffuse peritonitis—case report

Amyand’s hernia, the presence of the vermiform appendix within an inguinal hernia sac, is a rare clinical entity (0.2%–1.7% of inguinal hernias). Acute appendicitis within the sac is rarer still, occurring in only 0.1% of cases. We describe a male patient presenting with an incarcerated right inguinal hernia, who developed diffuse peritonitis after manual reduction. Laparotomy revealed gangrenous perforated appendicitis with purulent peritonitis. Appendectomy, partial omentectomy, and peritoneal lavage were performed. The patient recovered uneventfully. Amyand’s hernia complicated by perforated appendicitis is an exceptional surgical emergency. Early recognition and prompt surgical management are crucial for favorable outcomes.