Edorium Journal of

Surgery

 
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Case Series
 
Amyand's hernia with appendicular perforation: A case series
Filipe Madeira Martins1, Henrique Morais2, Filipa Santos2, João Pinho2, Isabel Borges2, José Couceiro3
1MD, Serviço de Cirurgia 1, Hospital da Horta, E.P.E., Horta, Azores, Portugal.
2MD, Serviço de Cirurgia Geral, Hospital Distrital da Figueira da Foz, E.P.E., Figueira da Foz, Portugal.
3MD, Head of Department, Serviço de Cirurgia Geral, Hospital Distrital da Figueira da Foz, E.P.E., Figueira da Foz, Portugal.

Article ID: 100013S05FM2016
doi:10.5348/S05-2016-13-CS-3

Address correspondence to:
Filipe Madeira Martins
Hospital da Horta, Estrada Príncipe Alberto do Mónaco 9900-038 Horta
Azores
Portugal

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How to cite this article:
Martins FM, Morais H, Santos F, Pinho J, Borges I, Couceiro J. Amyand's hernia with appendicular perforation: A case series. Edorium J Surg 2016;3:9–12.


Abstract
Introduction: Amyand's hernia is an uncommon variant of inguinal hernias, which is defined by the presence of the appendix within the hernia sac. They can be classified into four types. There is not much literature about the subject and some issues remain controversial, such as the treatment options. Over 16 years (1996–2012) 2648 inguinal hernias were surgically intervened at Hospital Distrital da Figueira da Foz, Portugal, and two of them were Amyand's hernias representing an incidence of 0.076%.
Case Series: The patients are males, 72 and 76 years old, and presented right inguinal pain and tumor. In both cases, the diagnosis was made during emergency surgery and perforated appendicitis was found. Appendectomy through the herniotomy incision and primary prosthetic hernia repair with associated endovenous broad-spectrum antibiotic therapy was the treatment of choice. No significant morbidity or mortality was recorded.
Conclusion: The adequate surgical treatment depends on the type of Amyand's hernia. Appendectomy through the herniotomy incision and primary hernia repair seems to be the best treatment option for Amyand's hernia with acute appendicitis. The method of primary hernia repair is, however, controversial. Some authors stand for a prosthetic hernia repair and endovenous broad-spectrum antibiotic therapy, with good results. Appendectomy is not an absolute contraindication to primary prosthetic hernia repair. More studies are needed to acknowledge the best surgical approach concerning the different types of Amyand's hernia.

Keywords: Hernia mesh, Hernioplasty, Inguinal hernia, Perforated appendicitis


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Author Contributions:
Filipe Madeira Martins – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Henrique Morais – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Filipa Santos – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
João Pinho – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Isabel Borges – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
José Couceiro – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Filipe Madeira Martins et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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