I Inan1, P O Myers, M E Hagen, M Gonzalez, P Morel. 1. Division of Visceral and Transplantation Surgery, Department of Surgery, University Hospital of Geneva, Geneva, Switzerland. ihsan.inan@hcuge.ch
Abstract
BACKGROUND: Amyand's hernia is an atypical groin hernia which contains the vermiform appendix. The aim of this study was to review a single institution's experience in the clinical presentation, management and prognostic factors of this rare hernia. METHODS: The authors reviewed records of all patients undergoing hernia surgery from 1996 to 2006 at their institution, a tertiary care, University-affiliated hospital. RESULTS: Twelve patients (six men) with a median age of 88 years (range 60-97) were included. Six presented with right inguinal hernias and six presented with right femoral hernias. All required emergency surgery: eight for strangulated hernias, two for hernias with lower quadrant peritonism and two for incarcerated hernia. Despite small differences in outcome and length of hospitalisation between Amyand types, appendix inflammation, pre-operative blood examinations and hernia localisation, only right lower quadrant peritonism as a presenting sign (p=0.004) and age greater than 90 years old (p=0.04) were significantly associated with a poor outcome. CONCLUSION: Amyand's hernia is a rare hernia which is seldom diagnosed before operation. It must be considered in the evaluation of a strangulated or incarcerated hernia. Further studies are required to define the optimal surgical strategy, prognostic factors and risks of hernia recurrence.
BACKGROUND: Amyand's hernia is an atypical groin hernia which contains the vermiform appendix. The aim of this study was to review a single institution's experience in the clinical presentation, management and prognostic factors of this rare hernia. METHODS: The authors reviewed records of all patients undergoing hernia surgery from 1996 to 2006 at their institution, a tertiary care, University-affiliated hospital. RESULTS: Twelve patients (six men) with a median age of 88 years (range 60-97) were included. Six presented with right inguinal hernias and six presented with right femoral hernias. All required emergency surgery: eight for strangulated hernias, two for hernias with lower quadrant peritonism and two for incarcerated hernia. Despite small differences in outcome and length of hospitalisation between Amyand types, appendix inflammation, pre-operative blood examinations and hernia localisation, only right lower quadrant peritonism as a presenting sign (p=0.004) and age greater than 90 years old (p=0.04) were significantly associated with a poor outcome. CONCLUSION: Amyand's hernia is a rare hernia which is seldom diagnosed before operation. It must be considered in the evaluation of a strangulated or incarcerated hernia. Further studies are required to define the optimal surgical strategy, prognostic factors and risks of hernia recurrence.
Authors: Ioannis Karanikas; Argyrios Ioannidis; Petros Siaperas; Georgios Efstathiou; Ioannis Drikos; Nicolaos Economou Journal: J Med Case Rep Date: 2015-05-28