The role of prosthetic repair in the treatment of an incarcerated recurrent inguinal hernia with acute appendicitis (inflamed Amyand's hernia)
2nd Department of Surgery, Medical School, Aristotle University of Thessaloniki, "G. Gennimatas" Hospital, Ethnikis Aminis 41, 54635, Thessaloniki, Greece, .Hernia (Impact Factor: 2.05). 06/2009; 13(3):335-6; author reply 337. DOI: 10.1007/s10029-009-0505-2
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- "However, in case of inflamed appendix in the sac, appendectomy without mesh hernia repair is suggested by some authors . Nonetheless, some prefer to perform both appendectomy and mesh hernia repair in the treatment of inflamed appendix in the inguinal hernia sac, and they recommended the intravenous broad-spectrum antibiotics for at least 3-5 days to prevent a possible mesh infection . Additionally, Torino et al  irrigated the inguinal area with antibiotics. "
ABSTRACT: Existence of non-inflamed or inflamed vermiform appendix in an inguinal hernia is named Amyand's hernia in honor to the surgeon Claudius Amyand who successfully performed first perforated appendicitis. A 69-year-old Turkish male patient with a slight right groin pain and swelling was presented to our clinic, and found to have a slightly tender and reducible right inguinal hernia. He underwent surgery under general anesthesia, and a adhesive caecum and an inflamed appendix were explored within the hernia sac. Adhesions were divided by sharp dissection and appendectomy was performed. After carrying out a Lichtenstein hernioplasty, a broad-spectrum antibiotic was postoperatively admitted for 3 days. He recovered uneventfully, and neither complication nor recurrence was detected during 52 months of follow-up. Although occurrence of an appendicitis in an inguinal hernia is rare, a surgeon should be vigilant for facing with it even in elective cases. Treatment can be provided only surgically, but surgical treatment is not standard except from appendectomy. In our opinion, application of mesh hernia repair should depend on the degree of inflammation of appendix and the presence of incarceration of hernia sac with a suitable antibiotic admission for 3-5 days postoperatively.
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ABSTRACT: A 53-year-old man with an Amyand hernia with indirect and direct components was repaired with a Bio-A (Gore, Newark, Delaware) plug and a patch made of Bio-A tissue reinforcement material. The repair of an Amyand hernia addresses the pathology of the appendix as well as the hernia. We report a case in which a plug and patch repair was undertaken using Bio-A implants in a clean-contaminated field with no signs of infection or recurrence in the follow-up period, and we review the literature regarding the diagnosis and repair of an Amyand hernia.
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ABSTRACT: We present a case of Amyand’s hernia with acute suppurative appendicitis. This variety is a surgical emergency requiring prompt appendectomy. Key wordsAmyand’s hernia–Hernial appendicitis–Incarcerated hernia
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