İnguinal Herni Cerrahisinde Nadir Görülen Bir Durum,Amyand Herni; Kohort Analizi

Yıl 2018, Cilt: 1 Sayı: 3, 103 - 105, 14.12.2018

Süleyman Kargın , Ersin Turan

https://doi.org/10.33713/egetbd.453068

Öz

Amaç

Amyand herni inflame olsun ya da olmasın fıtık kesesi  içinde apendix vermiformisin bulunmasıdır. İngüinal herni cerrahisi sırasında tespit edilen bu durum karşısında apendektomi yapılıp yapılmayacağı halen tartışmalıdır. Bu çalışmada kliniğimizde Amyand herni tespit edilen  hastaların cerrahi sonuçlarını sunmayı amaçladık.

Gereç ve Yöntem

Farklı iki merkezde ingüinal herni nedeniyle  opere edilen 2831 hasta içinden Amyand herni tanısı alan 14 hastanın dosyaları retrospektif incelendi. Hastaların demografik verileri, Losanoff ve Basson tipleri, ameliyat türleri, postoperatif seyirleri ve patolojik sonuçları değerlendirildi. 

Bulgular

Hastaların 6(%42.8)sına acil 8’i elektif cerrahi yapılmıştı.8 hastada akut apandisit mevcutken 6 hastada apendiks normaldi. Losanoff ve Basson tip 1 olan 4 hastaya apendetomisiz yamalı fıtık tamiri, 1 hastaya apendektomi ve yamalı fıtık tamiri; tip 2 olan 4 hastaya apendektomi ve yamalı fıtık tamiri; tip 3 olan 5 hastaya apendektomi ve yamasız fıtık tamiri yapıldı.

Sonuç

 Amyand herni nadir görülen  bir durumdur. Preoperatif  tanısı oldukça zordur. Tedavinin tam ve doğru olarak gerçekleştirilmesi için herni cerrahisi ile ilgilenen cerrahların dikkatli olması gerekmektedir.

Aim

Amyand Hernia is presence of appendix vermiformis in the hernia sac whether appendix have inflammation or not. Appendectomy should be performed is still controversial in the face of this condition that was detected during inguinal hernia surgery. In this study, we aimed to present the surgical results of patients with Amyand hernia in our clinic.

Materials and Methods

Retrospectively reviewed the data of 14 patients who were diagnosed with Amyand hernia during the operation from 2831 patients who were operated on for inguinal hernia. Demographic data of patients, Losanoff and Basson classification types, types of surgery, postoperative course and pathological results were evaluated.

Results

Six of the patients (42.8%) underwent elective emergency surgery. While 8 patients had acute appendicitis, 6 patient’s appendix vermiformis was normal. Four patients with Losanoff and Basson classification type 1 repaired with mesh and without appendectomy, 1 patient were performed appendectomy and repaired with mesh; 4 patients with type 2 were performed appendectomy and with mesh hernia repair; 5 patients with type 3 were performed appendectomy and without mesh hernia repair.

Conclusion

 Amyand hernia is a rare condition. Preoperative diagnosis is very difficult. Surgeons interested in hernia surgery must be careful to ensure that the treatment is complete and accurate

Anahtar Kelimeler

Amyand Herni, apendiks, Losanoff ve Basson

Kaynakça

• 1. Amyand C. Of an inguinal rupture, with a pin in the appendix caeci, incrusted with stone; and some observations on wounds in the guts. Philos Trans R Soc Lond. 1736; 39: 329–336
• 2. Losanoff JE, Basson MD. Amyand hernia: a classification to improve management. Hernia. 2008; 12: 325–6
• 3. Bendavid R. Sliding hernias. Hernia. 2002; 6: 137-140
• 4. Solecki R, Matyja A, Milanowski W. Amyand's hernia: a report of two cases. Hernia. 2003; 7: 50-51
• 5. Öztürk E, Garip G, Yılmazlar T. Amyand herni. Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2004; 30: 225-226
• 6. Ali SM, Malik KA, Al-Qadhi H. Amyand’s hernia: study of four cases and literature review. SQU Medical Journal. 2012; 12: 232–236
• 7. Sharma H, Gupta A, Shekhawat NS: Amyand’s hernia: a report of 18 consecutive patients over a 15-year period. Hernia. 2007; 11: 31–35
• 8. Hutchinson R: Amyand’s hernia. J R Soc Med. 1993; 86: 104–105
• 9. Lyass S, Kim A, Bauer J. Perforated appendicitis within an inguinal hernia: Case report and review of the literature. Am J Gastroenterol. 1997; 92: 700–702
• 10. Ash L, Hatem S, Ramirez GAM, Veniero J. Amyand's hernia: a case report of prospective CT diagnosis in the emergency department. Emerg Radiol. 2005; 11: 231-232
• 11. D’Alia C, Lo Schiavo MG, Tonante A et al. Amyand’s hernia: case report and review of the literature. Hernia. 2003; 7: 89-91
• 12. Ballas K, Kontoulis T, Skouras C et al. Unusual findings in inguinal hernia surgery: Report of 6 rare cases. Hippokratia. 2009; 13: 169-171
• 13. Milanchi S, Allins AD. Amyand’s hernia: history, imaging, and management. Hernia. 2008; 12: 321-322
• 14. Salemis NS, Nisotakis K, Nazos K, Savrinou P, Tsohataridis E. Perforated appendix and periappendicular abscess within an inguinal hernia. Hernia. 2006, 10: 528-530
• 15. Chatzimavroudis G, Papaziogas B, Koutelidakis I et al: The role of prosthetic repair in the treatment of an incarcerated recurrent inguinal hernia with acute appendicitis (inflamed Amyand’s hernia). Hernia, 2009; 13: 335–336