Advertisement

Amyand appendicitis

Published:March 31, 2022DOI:https://doi.org/10.1016/j.surg.2022.02.013
      An 85-year-old man presented to the emergency department with a 2-day history of right lower quadrant abdominal pain radiating to his groin. He had a history of hypercholesterolemia managed with cholesterol-lowering therapy. On examination, he had a low-grade temperature of 37.9°C, was normotensive at 130/70 mm Hg, tachycardic at 110 beats per minute, tachypnoeic with a respiratory rate of 20, and was saturating at 95% on room air. On palpation, he had a tender lump in his right inguinal region, without evidence of peritonism. His blood tests revealed an elevated white cell count of 12 × 109/L and an elevated C-reactive protein of 30 mg/L. Computed tomography (CT) of the abdomen and pelvis was performed. On review of the imaging (Figure 1), what diagnosis explains this patient’s clinical presentation?
      • A)
        Berger’s hernia
      • B)
        Maydl hernia
      • C)
        Amyand hernia with appendicitis
      • D)
        Littre hernia with Meckel’s diverticulitis
      Figure thumbnail gr1
      Figure 1Coronal CT of the abdomen demonstrates a right sided inguinal hernia containing the appendix. There is also abnormal dilatation of the appendix, wall thickening, periappendiceal fat stranding, and free fluid in keeping with acute appendicitis.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Mongardini M.
        • Maturo A.
        • De Anna L.
        • et al.
        Appendiceal abscess in a giant left-sided inguinoscrotal hernia: a rare case of Amyand hernia.
        Springerplus. 2015; 4: 1-4
        • Losanoff J.
        • Basson M.
        Amyand hernia: a classification to improve management.
        Hernia. 2008; 12: 325-326
        • Holmes K.
        • Guinn J.E.
        Amyand hernia repair with mesh and appendectomy.
        Surg Case Rep. 2019; 5: 42