Ectopic Appendicitis in Amyand's Hernia: Case Report of a Rare Clinical Challenge.

Abstract Background - Inguinal hernias containing the appendix are rare, but the occurrence of acute appendicitis within the hernia sac is an even more exceptional event that entails a difficult diagnosis and a non-unique surgical treatment. Case presentation – A male in his seventies presented to the Emergency Department with acute lower abdominal pain and a painful irreducible right inguinal swelling. CT suggested a complicated hernia, while surgery confirmed an Amyand’s hernia containing a gangrenous appendicitis with microperforation. The patient underwent appendicectomy and hernia mesh repair and was discharged after an uneventful postoperative recovery. Conclusion - Acute appendicitis in an Amyand’s hernia is a rare condition and constitutes both a diagnostic and therapeutic challenge for acute care surgeons. Keyword: Amyand’s hernia, Acute appendicitis, Mesh repair, Losanoff classification.