Amyand Hernia: A Case Report with a Review of the Literature

Amyand hernia is an uncommon type of inguinal hernia where the vermiform appendix is found within the hernia sac. It represents 0.19%–1.7% of all inguinal hernia cases. Due to its rarity, Amyand hernia poses a diagnostic challenge, particularly in the preoperative phase. We present the case of a 70-year-old male who was diagnosed with a right-sided Amyand hernia during an open mesh hernioplasty performed under spinal anesthesia. Intraoperatively, the appendix was discovered within the hernia sac, appearing grossly normal without any signs of inflammation or adhesions. The contents of the hernia were reduced, and the hernia was repaired using mesh, without the need for an appendectomy. Amyand hernia is often incidentally diagnosed during surgery due to its nonspecific clinical presentation. The management of this condition can vary, particularly in deciding whether to perform an appendectomy when the appendix is not inflamed. In this case, considering the normal appearance of the appendix and absence of inflammation, the patient was managed with mesh repair alone, aligning with the Losanoff and Basson classification. Given its rarity and diagnostic challenges, Amyand hernia requires a high index of suspicion, especially in atypical presentations of inguinal hernias. Surgical management should be tailored to the condition of the appendix, with appendectomy reserved for cases where the appendix shows signs of inflammation or other pathology.