A Case of Amyand’s Hernia with Abscess

Abstract

The subject was an 83-year-old man who visited our emergency room with the chief complaint of swelling accompanied by pain in the right inguinal region. Swelling and redness of the size of a fist were observed in the region extending from the right inguinal region to the scrotum. CT revealed a strangulated right inguinal hernia with findings suggestive of intestinal ischemia, and emergency surgery was performed. The vermiform appendix had prolapsed from the cecum into the hernia sac, with abscess formation found in the scrotum. In addition to using the inguinal approach, we also made a longitudinal incision in the scrotum in order to remove excise the abscess together with its capsule, after which the cecum was resected and radical hernia surgery was performed. Although the precise course of development is unknown, hernia incarceration of the cecum is believed to have occurred concurrently with appendicitis, followed by perforation and abscess formation in the hernia sac. The patient made good clinical progress and was discharged on the 8th postoperative day. Although cases of Amyand’s hernia, in which the vermiform appendix prolapses into the hernia sac, have been reported, it is uncommon to encounter cases in which appendicitis and abscess formation occur in the hernia sac, as in our present case reported here. We report this case, with some discussion of the pertinent literature.