Amyand’s hernia in a 5-year-old child: a case report
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Amyand’s hernia is a rare type of inguinal hernia where the appendix is located within and/or incarcerated in the hernia sac [1]. Studies claim that Amyand’s hernia occurs in 1% of all inguinal hernias, and the presence of appendicitis within an Amyand’s hernia accounts for 0.1% of all appendicitis. Amyand’s hernia has been reported in patients ranging in age from 3 weeks to 92 years and is three times more likely to be diagnosed in children than in adults due to the patency of the processus vaginalis in the pediatric population. Most reported cases of Amyand’s hernia have been seen in the right inguinal region. Although common in an inguinal hernia, the appendix has been reported to be found in incisional, obturator or umbilical hernias.

A 5-year-old boy presented to our institute with the complaints of pain in the right groin for 2 days, which was acute in onset and mild to moderate in intensity. Pain was not associated with nausea and vomiting. On examination, it was found to be a case of right-sided irreducible inguinal hernia. There was no evidence of abdominal distension. Laboratory parameters were within normal limits. An ultrasound exam was not performed as the diagnosis was made via clinical examinations. Surgical exploration was done under general anesthesia. The inguinal canal was opened through lower transverse abdominal skin crease, and herniotomy was planned.

However, as the sac was opened, the appendix and caecum could be identified as its content with mild adhesion within. Consent for the appendectomy was taken from the parents intraoperatively before proceeding for an appendectomy. Further, the caecum was reduced, and the hernial sac was transfixed with Vicryl 3-0 RB and divided. External aponeurosis was closed. Likewise, skin was closed subcuticularly with Vicryl 3-0 RB. Postoperative period was uneventful. Patient was discharged on second postoperative day. On follow-up, the patient was completely fine and the wound was healthy.