APPENDICITIS WITHIN RECURRENT HERNIA ON GERIATRIC PATIENT: AN UNUSUAL AMYAND'S HERNIA

Year 2018, , 145 - 149, 27.08.2018

Serhan Derici , Ali Kadir Değirmenci Ali Durubey Evlik

https://doi.org/10.5505/deutfd.2018.07269

Abstract

In a 73 year old male patient who admitted to
emergency service with general medical condition disorder, high fever,
unconsciousness, had no abdominal complaints prior to admission and had a right
inguinal hernia surgery twice, one due to recurrence in the medical history,
recurrent right Amyand hernia and appendicitis were detected. A laparoscopic
appendectomy was performed in this atypical clinic. Although  appendicitis  due to Amyand hernia  is observed in less than 0.1% of patients, by
sharing this patient’s findings and treatment protocol whose second recurrence
of hernia  has developed as  Amyand, it was aimed to remind that
especially appendicitis in the hernia sac may lead to a systemic infection
clinic without localized peritonitis findings and even in patients who have
undergone multiple hernia operations, recurrent / indirect inguinal hernia may
be present.

Keywords

Amyand's hernia, groin hernia, appendicitis, peritonitis

Geriyatrik hastada tekrarlayan kasık fıtığında akut apandisit: Ender bir amyand herni olgusu

Abstract

Acil servise genel durum bozukluğu,
ateş yüksekliği ve bilinç bulanıklığı ile başvuran, başvuru öncesi herhangi bir
abdominal şikâyeti olmayan ve tıbbi özgeçmişinde biri nüks nedeniyle olmak
üzere iki defa sağ kasık fıtığı ameliyatı olan 73 yaşındaki erkek hastada, nüks
sağ Amyand herni ve apandisit saptanmıştır. Atipik kliniği olan bu hastaya
laparoskopik appendektomi yapılmıştır. Amyand hernide apandisit gelişme
olasılığı %0.1’den az iken, ikinci nüks hernisi Amyand olarak gelişen bu
hastanın bulguları ve uygulanan tedavi paylaşılarak, özellikle fıtık kesesi
içerisindeki apandisitin, lokalize peritonit bulguları olmadan sistemik
enfeksiyon kliniğine yol açabileceği, birden çok defa herni operasyonu geçiren
hastalarda dahi nüks/atlanmış indirek inguinal herni olabileceği hatırlatılmak
istenmiştir.

Keywords

Amyand herni, kasık fıtığı, apandisit, peritonit

References

• Singal R, Gupta S. “Amyand’s Hernia” – Pathophysiology, Role of Investigations and Treatment. Maedica (Burcahr). 2011;6(4):321–7.
• Inan I, Myers PO, Hagen ME, Gonzalez M, Morel P. Amyand’s hernia: 10 years’ experience. Surgeon 2009;7(4):198–202.
• Morales-Cárdenas A, Ploneda-Valencia CF, Sainz-Escárrega VH, Hernández-Campos AC, Navarro-Muñiz E, López-Lizarraga CR, et al. Amyand hernia: Case report and review of the literature. Ann Med Surg. 2015;4(2):113–5.
• Kaymakci A, Akillioglu I, Akkoyun I, Guven S, Ozdemir A, Gulen S. Amyand’s hernia: a series of 30 cases in children. Hernia. 2009;13(6):609–12.
• Hutchinson R. Amyand’s hernia. J R Soc Med. 1993;86: 104–5.
• Suppiah A, Dharmlingum A, Swift S, Smith A. Acute appendicitis within a recurrent inguinal hernia presenting as epididymo-orchitis. J Surg Case Rep. 2012;2012:12.
• Barut I, Tarhan Ö̈ R. A rare variation of Amyand’s hernia: Gangreneous appendicitis in an incarcerated inguinal hernia sac. Eur J Gen Med. 2008;5:112–4.
• Meinke AK. Review article: Appendicitis in groin hernias. J Gastrointest Surg. 2007;11:1368–72.
• Bay-Nielsen M, Nordin P, Nilsson E, Kehlet H. Operative findings in recurrent hernia after a Lichtenstein procedure. Am J Surg. 2001;182:134–6.
• Michalinos A, Moris D, Vernadakis S. Amyand’s hernia: A review. Am J Surg. 2014;207:989–95.
• Elbanna KY, Alzahrani HA, Azzumeea F, Alzamel HA. Neuroendocrine tumor of the appendix inside an incarcerated Amyand’s hernia. Int J Surg Case Rep 2015;14:152–5.