Amyand Hernia

Amyand Hernia

  • The appendix is thought to herniate through a patent processus vaginalis.
  • The vermiform appendix can remain in the hernia sac without symptoms indefinitely. It has been suggested that the neck of the hernia can strangle the appendix and cause acute appendicitis.
  • Recent reports show that if treated properly, it does not add morbidity or mortality beyond that of a typical inguinal hernia
  • Many patients present with symptoms typical of an inguinal hernia
  • Management: guided by categorization of the Amyand’s hernia as follows:
    – Normal appendix: Reduction or appendectomy, mesh hernioplasty
    – Acute appendicitis localized in the sac: Appendectomy through hernia, endogenous repair
    – Acute appendicitis, peritonitis: Appendectomy through laparotomy, endogenous repair
  • In hernia repair, the use of mesh should be avoided in cases of appendicitis, because it can cause mesh infection and sepsis.

Reference: radiopaedia.org, http://www.auntminnie.com/index.aspx?sec=olce&sub=cotx&pag=cpages&ce_id=7279&section_id=7318&pno=5

 

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