A Case of an Incarcerated Amyand’s Hernia Diagnosed with Preoperative Clinical Imaging Modalities

Abstract

An 80-year-old man was referred to our hospital for a right inguinal mass and anorexia. Ultrasonography revealed a tubular structure from the abdominal cavity through the right inguinal canal. Abdominal enhanced computed tomography demonstrated the inflamed tubular structure trapped within a right indirect inguinal hernia. The tubular structure connected with the cecum and ended in the hernia sac. We diagnosed the condition as an incarcerated Amyand’s hernia with appendicitis, based on the clinical imaging. We started the operation with a right inguinal incision, and identified the hernia sac protruding through the inner inguinal ring. We further defined the incarcerated vermiform appendix with localized abscess formation in the hernia sac. Upon exploration of the peritoneal cavity, no existence of inflammation or infection was confirmed. Thus an appendectomy and primary hernioplasty with McVay repair were performed. The postoperative course was uneventful and the patient was discharged on the fourth day after surgery. Amyand’s hernia is a rare type of inguinal hernia containing the vermiform appendix. We report herein a case of Amyand’s hernia with a literature review of previous cases in Japan.