A Rare Case of Laparoscopic Surgery for Internal Surpravesical Type of Amyand’s Hernia

Abstract

Amyandʼs hernia is a rare case of inguinal hernia which involves herniation of the appendix. We report an extremely rare condition of Amyandʼs hernia which protruded through the internal supravesical fossa. A female in her mid-twenties, who had a history of acute appendicitis treated with an antibiotics 6 months ago, had suffered from right lower quadrant pain and a groin mass for a month. The groin mass had already diminished spontaneously on the initial visit of our hospital, but computed tomography revealed an inflamed appendix with appendiceal abscess located in the internal supravesical fossa. Laparoscopy operation was performed for chronic appendicitis concomitant with abdominal wall abscess. We recognized that an inflamed appendix was incarcerated in the hernia orifice of supravesical fossa. Partial resection of the cecum was performed by using a stapling device and incarcerated appendix was removed. The tension-free prosthesis repair was not employed due to the risk of infection and the drainage tube was placed. Post-operative course was uneventful and recurrent inguinal hernia has not been encountered with 12 months after surgery. Laparoscopic surgery is thought to be useful for the diagnosis of Amyandʼs hernia and has an advantage in the surgical approach for incarcerated appendix.