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Preoperative diagnosis of Amyand's hernia by ultrasound and computed tomography

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ABSTRACT

Inguinal hernia is the most common seen groin hernias which mostly contain bowel. The incidence of vermiform appendix in an inguinal hernia is seen in 1% of all inguinal hernia. This is known as Amyand's hernia. Appendix within a hernia can be normal or complicated by appendicitis. Most of these cases are not diagnosed preoperatively and managed during surgery. Preoperative diagnosis of these cases is so rare. Very few cases have been reported so far.

In our case, we diagnosed an inflamed appendix in a 49 years old female within right inguinal hernia by using ultrasound and confirmed it by CT scan.

No MeSH data available.


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Ultrasound of the inguinal mass, showing blind-ended tubular structure with a thick wall (Fig. 2) inside hernia sac (Fig. 1), corresponding to the incarcerated appendix.
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fig1: Ultrasound of the inguinal mass, showing blind-ended tubular structure with a thick wall (Fig. 2) inside hernia sac (Fig. 1), corresponding to the incarcerated appendix.

Mentions: A 49-year-old female was referred to our emergency department with a right-sided groin pain and swelling. The routine lab test showed an increase in white blood cells and CRP. Clinical examination revealed tenderness and a mass in the right groin that increased during Valsalva maneuver. Ultrasound examination showed right inguinal hernia containing small intestine loop and an 8 mm tubular noncompressing structure resembling appendicitis (Fig. 1, Fig. 2). IV Contrast enhanced CT scan confirmed the diagnosis, showing a blinded thickened tubular appendix arising from the caecum and entering the inguinal canal (Fig. 3). During the operation, an inflamed appendix with appendiceal fecalith was found within the hernia sac. Appendectomy and hernia repair were performed (Fig. 4). Histopathology results confirmed the diagnosis of acute appendicitis. The postoperative course was uneventful, and the patient was discharged without any complications.


Preoperative diagnosis of Amyand's hernia by ultrasound and computed tomography
Ultrasound of the inguinal mass, showing blind-ended tubular structure with a thick wall (Fig. 2) inside hernia sac (Fig. 1), corresponding to the incarcerated appendix.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5121267&req=5

fig1: Ultrasound of the inguinal mass, showing blind-ended tubular structure with a thick wall (Fig. 2) inside hernia sac (Fig. 1), corresponding to the incarcerated appendix.
Mentions: A 49-year-old female was referred to our emergency department with a right-sided groin pain and swelling. The routine lab test showed an increase in white blood cells and CRP. Clinical examination revealed tenderness and a mass in the right groin that increased during Valsalva maneuver. Ultrasound examination showed right inguinal hernia containing small intestine loop and an 8 mm tubular noncompressing structure resembling appendicitis (Fig. 1, Fig. 2). IV Contrast enhanced CT scan confirmed the diagnosis, showing a blinded thickened tubular appendix arising from the caecum and entering the inguinal canal (Fig. 3). During the operation, an inflamed appendix with appendiceal fecalith was found within the hernia sac. Appendectomy and hernia repair were performed (Fig. 4). Histopathology results confirmed the diagnosis of acute appendicitis. The postoperative course was uneventful, and the patient was discharged without any complications.

View Article: PubMed Central - PubMed

ABSTRACT

Inguinal hernia is the most common seen groin hernias which mostly contain bowel. The incidence of vermiform appendix in an inguinal hernia is seen in 1% of all inguinal hernia. This is known as Amyand's hernia. Appendix within a hernia can be normal or complicated by appendicitis. Most of these cases are not diagnosed preoperatively and managed during surgery. Preoperative diagnosis of these cases is so rare. Very few cases have been reported so far.

In our case, we diagnosed an inflamed appendix in a 49 years old female within right inguinal hernia by using ultrasound and confirmed it by CT scan.

No MeSH data available.


Related in: MedlinePlus