Annals of Case Reports and Clinical Studies (ISSN: 2834-5673) | Volume 5, Issue 4 | Case Report | Open Access
Anand A*
Maulana Azad Medical College and associated LNH, GIPMER and GNEC, New Delhi, India
Fulltext PDFBackground: Amyand’s hernia, defined as the presence of the vermiform appendix within an inguinal hernia sac, is an uncommon surgical entity, rarely complicated by appendicitis. Preoperative diagnosis remains challenging due to overlapping clinical features with other inguinal pathologies.
Objective: To describe a rare case of Amyand’s hernia complicated by appendicitis and present a systematic review and pooled meta-analysis of published cases to evaluate clinical characteristics, diagnostic approaches, and surgical management outcomes.
Methods: Following PRISMA guidelines, a comprehensive PubMed search from January 2014 to August 2024 identified case reports, case series, and retrospective reviews of adult patients with Amyand’s hernia complicated by appendicitis. Data on demographics, diagnostics, management strategies, and outcomes were extracted and analyzed using R software, with categorical variables compared via χ² and Fisher’s exact tests.
Results: Fifty-five studies (59 patients) met inclusion criteria. The mean patient age was 63.5 ± 20.3 years, with an 86.4% male predominance. Right-sided involvement occurred in 93.2% of cases. Preoperative diagnosis of Amyand’s hernia with appendicitis was achieved in only 37.3% of patients, with computed tomography being the most accurate modality (52.5%). Most patients (76.3%) underwent emergency surgery, predominantly via open approach (73.3%), while laparoscopic intervention was more common in elective settings. Non-mesh hernia repair (herniorrhaphy) was favored in inflamed or contaminated fields (66.6%, p < 0.05). Postoperative complications were rare, with isolated cases of mesh infection, renal failure, and death unrelated to procedure type.
Case Summary: A 39-year-old male presented with right lower quadrant pain diagnosed as acute appendicitis. Intraoperatively, an inflamed, pus-filled appendix was found extending into the deep inguinal ring. Laparoscopic appendectomy and herniorrhaphy without mesh were performed, yielding uneventful recovery.
Conclusion: Amyand’s hernia complicated by appendicitis remains a diagnostic and therapeutic challenge. Laparoscopic appendectomy with individualized hernia repair based on inflammatory severity is safe and effective. Consistent case reporting is essential to refine management strategies and improve outcomes for this rare condition.
Anand A. Amyand’s Hernia with Acute Appendicitis: A Case Report of a Type 2 Amyand’s Hernia with Literature Review. Ann Case Rep Clin Stud. 2026;5(4):1-23.