Amyand's Hernia: Case Report Resolved by Minimally Invasive Approach

Abstract

Amyand's hernia is a rare anatomical variant characterized by the presence of the vermiform appendix within the inguinal hernial sac. Its diagnosis is usually an incidental intraoperative finding because its clinical presentation mimics a conventional incarcerated inguinal hernia.

The case is about a 56-year-old male with a right inguinoscrotal hernia of two years' duration presented with incarceration and acute pain. A transabdominal preperitoneal laparoscopic approach (TAPP) was performed, identifying a hernial defect containing healthy appendix, cecum, and ascending colon (sliding hernia). Following the Losanoff and Basson classification, it was categorized as Type 1. The contents were reduced without appendectomy, the defect was closed, and repaired with a polypropylene mesh fixed with medical cyanoacrylate. The patient recovered well, was discharged early, and had no complications during follow-up.

Amyand's hernia requires a high index of clinical suspicion and individualized surgical management. In cases with a healthy appendix, preserving the organ allows for the safe use of prosthetic material, minimizing the risk of infection. The laparoscopic approach stands out as an effective tool for accurate diagnosis and minimally invasive treatment, optimizing postoperative recovery.