Clinical features of Amyand’s hernia: from intraoperative finding to successful repair

Amyand’s hernia is rare among inguinal hernias (< 1% of patients). Inflammation of appendix in hernial sac is observed in less than 0.1% of cases. Diagnosis of this hernia is difficult because preoperative diagnostic methods often fail to visualize appendix. Thus, final diagnosis is often established intraoperatively. The authors present successful treatment of Amyand’s hernia in a 54-year-old patient with recurrent inguinal hernia and 3 previous surgical corrections (the last one 7 years ago). Hernia was characterized by periodic self-reduction of protrusion. Within 72 hours before hospitalization, there were acute pain, local skin hyperemia, and no manual reduction of protrusion. This indicated strangulation of appendix. Preoperative examination revealed signs of inflammation and dilation of inguinal canal with hernial sac. The patient was diagnosed with unilateral or unspecified inguinal hernia without obstruction or gangrene with suspected strangulation of appendix. Surgical intervention was performed using open Lichtenstein hernia repair with appendectomy. No postoperative complications were observed, and follow-up confirmed no hernia recurrence.