EMERGENCY SURGICAL MANAGEMENT OF AMYAND HERNIA: A CASE SERIES STUDY

Cătălin  Cosma; Marian  Botoncea; Cosmin  Nicolescu; Călin  Molnar

doi:10.33695/rojes.v5i2.76

Cătălin Cosma Emergency County Clinical Hospital Tg.Mureș (SCJU) & George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș
Marian Botoncea Emergency County Clinical Hospital Tg.Mureș (SCJU) & George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș
Cosmin Nicolescu Emergency County Clinical Hospital Tg.Mureș (SCJU) & George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș
Călin Molnar Emergency County Clinical Hospital Tg.Mureș (SCJU) & George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș

DOI: https://doi.org/10.33695/rojes.v5i2.76

Keywords: Amyand hernia, appendectomy, inguinal hernia, emergency surgery

Abstract

Introduction: Amyand’s hernia, named after Claudius Amyand, is a rare hernia variant characterized by the presence of the vermiform appendix within the hernial sac. Accounting for about 1% of all inguinal hernias, its exact development mechanism remains unclear. The clinical presentation can vary significantly, often mirroring symptoms of a hernia or acute appendicitis.

Material & Method: A retrospective case series study was conducted at the General Surgery Clinic 1 of the SCJU Tg. Mures Emergency County Hospital. It involved a comprehensive review of medical records of patients diagnosed with Amyand’s hernia who underwent emergency surgery. Data collected included demographics, clinical presentation, surgical management, postoperative complications, and follow-up details. Descriptive statistical analysis was performed using EasyMedStat software.

Results: Over five years, seven cases of Amyand’s hernia were reported, with an increase in 2023. The average age of the patients was 77.8 years, all male, demonstrating a higher incidence in older males. Symptom onset varied widely, from four months to nearly 20 years. Most patients experienced abdominal pain, with approximately half reporting fever. The primary diagnosis was often intestinal occlusion with an incarcerated inguinal-scrotal hernia. Surgical approaches varied, with the Lichtenstein operation being the most common. Mesh repair was used in most cases, and all patients underwent appendectomy. The median hospital stay was five days, with minimal postoperative complications.

Conclusion: Amyand’s hernia presents a surgical challenge due to its rarity and variable clinical presentation. This study underscores the need for individualized treatment strategies to optimize patient outcomes. The findings contribute to understanding Amyand’s hernia, highlighting the importance of tailored surgical approaches and diligent postoperative care.

References

1. Lee, C. H., Chien, L. J., Shen, C., & Su, Y. (2022, October 1). Amyand’s hernia. The American Journal of the Medical Sciences. https://doi.org/10.1016/j.amjms.2022.05.006
2. Patoulias, D., Kalogirou, M., & Patoulias, I. (2017, January 1). Amyand’s Hernia: an Up-to-Date Review of the Literature. Acta Medica. https://doi.org/10.14712/18059694.2018.7
3. Morales, M., Ghzal, Y. E. K., & Medina, E. S. (2019, August 1). Hernia de Amyand. Cirugía Española. https://doi.org/10.1016/j.ciresp.2018.12.011
4. Mebis, W., Hoste, P., & Jager, T. (2018, January 1). Amyand’s Hernia. Journal of the Belgian Society of Radiology. https://doi.org/10.5334/jbr-btr.1402
5. Khalid, H., Khan, N. A., & Aziz, M. A. (2021, September 1). Amyand’s hernia a case report. International Journal of Surgery Case Reports. https://doi.org/10.1016/j.ijscr.2021.106332
6. Okita, A., Yoshida, O., & Murakami, M. (2020, April 1). Incarcerated Amyand’s Hernia. Acta Medica Okayama. https://doi.org/10.18926/amo/58277
7. Gao, Y., Zhang, T., Zhang, M., Hu, Z., Li, Q., & Zhang, X. (2021, July 23). Amyand’s hernia: a 10-year experience with 6 cases. BMC Surgery. https://doi.org/10.1186/s12893-021-01306-z
8. Tsalis, K., Symeonidis, S., Anestiadou, E., Bitsianis, S., Christidis, P., Loutzidou, L., Ouzounidis, N., Kotidis, E., Gemousakakis, G., & Angelopoulos, S. (2022, September 1). Amyand’s Hernia as a Random Finding in Acute Abdominal Pain and the Role of Thorough Investigation: a Case Report. PubMed. https://doi.org/10.26574/maedica.2022.17.3.720
9. Forrest, E., Fletcher, C., Budge, M., Lee, J. C., Grodski, S., & Serpell, J. W. (2021, October 6). Amyand hernia with acute appendicitis: management considerations. ANZ Journal of Surgery. https://doi.org/10.1111/ans.17259
10. Desai, G., Suhani, Pande, P., & Thomas, S. (2017, December 1). AMYAND’S HERNIA: OUR EXPERIENCE AND REVIEW OF LITERATURE. ABCD. https://doi.org/10.1590/0102-6720201700040014
11. Mathur, P., Mittal, P., & Kumar, A. (2023, January 1). Amyand’s hernia: Appendix in hernia or hernial appendicitis? Journal of Indian Association of Pediatric Surgeons. https://doi.org/10.4103/jiaps.jiaps_64_22
12. Manatakis, D. K., Tasis, N., Antonopoulou, M. I., Anagnostopoulos, P. V., Acheimastos, V., Papageorgiou, D., Fradelos, V. C., Zoulamoglou, M., Agalianos, C., Tsiaoussis, J., & Xynos, E. (2021, February 17). Revisiting Amyand’s Hernia: A 20-Year Systematic Review. World Journal of Surgery. https://doi.org/10.1007/s00268-021-05983-y
13. D’Alia C, Lo Schiavo MG, Tonante A, Taranto F, Gagliano E, Bonanno L, Di Giuseppe G, Pagano D, Sturniolo G. Amyand’s hernia: case report and review of the literature. Hernia. 2003 Jun;7(2):89-91. doi: 10.1007/s10029-002-0098-5. Epub 2003 January 15. PMID: 12820031.