Abstract / Summary
ABSTRACT: Amyand's hernia - rare type of inguinal hernia in which the vermiform appendix is situated inside a sac of inguinal hernia. It is noteworthy that this occurrence of left-sided Amyand's hernias without situs inversus or intestinal malrotation is quite rare because of the normal right-sided location of the appendix. This was found to be a surgical dilemma: the controversy of second surgery (appendicectomy) and the use of mesh, given that only 1% of all inguinal hernias are estimated to be Amyand's. A 61-year old male came to the out-patient department with progressively enlarging, bilateral inguinoscrotal swellings of over 10 years duration and was assessed for elective surgery to repair the condition. He was clinically examined and both inguinoscrotal hernias were completely reducible, and there were no signs of incarceration or strangulation. Intraoperatively, the left hernial sac contained a grossly normal vermiform appendix which was neither inflamed nor contaminated (Type I Amyand's hernia). Postherniorrhaphy days, day 1, the patient's postoperative course was uneventful, without any significant inguinal pain, and The patient was discharged postoperatively. He developed a bilateral inguinal seroma formation at outpatient follow-up on postoperative day 7 that was treated conservatively with needle aspiration alone under aseptic technique. Patient had no signs of recurrence or infection following the procedure and tolerated it well. On follow-up at postoperative day 14, complete resolution of seroma, along with its symptoms, was noted and the patient showed good wound healing without additional complications. Amyand's hernia on the left is a rare intra operative finding which can safely repair with mesh without the need for appendicectomy. The case does emphasize the need for careful intraoperative evaluation for proper surgical management and good short-term results for the preservation of the normal appendix. Keywords: Amyand's hernia, Left-sided Amyand's hernia, Type I Amyand's hernia, Inguinal hernia, Lichtenstein repair, Case report