- 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§ion_id=7318&pno=5