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12TH INTERCONTINENTAL EMERGENCY MEDICINE CONGRESS 12TH INTERNATIONAL CRITICAL CARE AND EMERGENCY MEDICINE CONGRESS, Antalya, Turkey, 17 - 20 April 2025, pp.334-335, (Summary Text)
Ref No: 4287
Amyand's hernia with appendicitis
Fikret Çelik1, Abdil Coşkun1, Murtaza Kaya1, Harun Yıldırım1, Ali Halıcı1, Ertan Sönmez1
1Kütahya Sağlık Bilimleri Üniversitesi
Introduction and Purpose: Hernia is the abnormal protrusion of an organ or tissue from its containing cavity. A non-reducible hernia is termed an incarcerated hernia. This report presents a rare case of an incarcerated appendix within a right inguinal hernia, also known as Amyand's hernia (AH). This case aims to raise awareness of this rare medical condition in emergency service.
Materials and Methods: Case Presentation A 76-year-old female patient presented to our emergency department with complaints of pain and swelling in the right lower quadrant for the past few days.Medical history:The patient has a history of diabetes mellitus, hypertension, and heart failure.The patient has no history of intra-abdominal surgery. She has no known allergies, and there are no significant findings in her family history.Vital signs: Heart rate: 87 bpm, Oxygen saturation: 92%, Temperature: 36.8°C, Blood pressure: 125/79 mmHg.Physical examination:A firm, irreducible inguinal hernia was detected in the right lower quadrant. The abdomen was soft, with no guarding or rebound tenderness.Laboratory findings:WBC: 24.84 × 10⁹/L, Neutrophil percentage: 86.9%, Hemoglobin: 10.7 g/dL, CRP: 170 mg/L, No other laboratory abnormalities were noted.Due to elevated acute-phase reactants and leukocytosis, IV Flagyl 500 mg was initiated, oral intake was stopped, and 0.9% saline infusion was started at 100 cc/hour.Since the patient's creatinine levels were within normal limits, a contrast-enhanced abdominal CT scan was performed.CT findings: The appendix was observed within the right inguinal canal, with an increased diameter of approximately 13 mm and surrounding heterogeneous fat stranding. There was linear density increase and heterogeneity in the pericecal fat tissue in the right lower quadrant.Following the CT findings, the general surgery department was consulted, and the patient underwent laparoscopic appendectomy. Postoperatively, the patient was started on analgesia and antibiotic therapy and was discharged after follow-up. The patient’s CT images
Results and Conclusion: Amyand’s hernia is a very rare surgical condition, affecting 1% of all inguinal hernia cases. What makes our case interesting is the inflammation of the appendix inside the Amyand hernia sac. Early diagnosis and surgery can prevent long-term complications.It is a condition that should always be kept in mind in patients with a hernia for early diagnosis and intervention in the emergency department.
Keywords: amyands hernia, surgical case reports, symptomatic hernia