Amyand’s Hernia – An Unusual Presentation of Common Ailment

Abstract Amyand hernia is a rare form of inguinal hernia in which the vermiform appendix is located within the hernial sac. The condition is commonly misdiagnosed as an incarcerated hernia, and its diagnosis is almost always made intraoperatively. A 74-year-old man presented with a 2-year history of right inguinoscrotal swelling associated with inguinal discomfort over the past 2 months. Initially, the swelling was reducible spontaneously. After a thorough history and clinical examination, the patient underwent a right inguinal mesh hernioplasty. During surgery, the hernial sac was identified and separated from the cord structures, and a diagnosis of right indirect inguinal hernia was confirmed. Upon opening the hernial sac, the caecum and the white-lily appendix were found inside. The hernial contents were reduced, and the hernia sac was transfixed and ligated with a 20 Vicryl suture at the deep inguinal ring. A 7 cm × 15 cm Prolene mesh was then placed for hernioplasty. The incision was closed back in layers, and an antiseptic dressing was applied. The patient was discharged on the 2 nd postoperative day and is on regular follow-up.