Preoperative diagnosis of Amyand’s hernia: About 3 cases.

Abstract

The Amyand’s hernia, presence of a vermiform appendix in inguinal hernia sac, represents about 0.13% of all acute appendicitis and 1% of all inguinal hernias. Although described more than 250 years ago, his preoperative diagnosis remains exceptional. We report 3 clinical cases of Amyand’s hernia, including a case of right inguinal hernia not strangled and two cases of right inguinal hernia strangled (1 case of recurrent right inguinal hernia strangulated and 1 case of appendicular peritonitis complicating strangulated hernia). An abdominopelvic CT-scan performed in 2 cases/3 allowed the diagnosis to be made. No imaging was performed in the case of recurrent inguinal hernia right strangled; In this case, Amyand’s hernia diagnosis was accidentally made intraoperatively. Laparoscopy localized the vermiform appendix in the hernia sac in the case of appendicular peritonitis complicating strangulated hernia. The 3 patients underwent surgery and the postoperative course was uneventful. Laparoscopy or imaging, especially CT-scanmakes preoperative diagnosis.