Amyand’s hernia complicated with perforated appendicitis in neonates: a case report

• Main Authors: Kamarul Zaman, Nabila Yuliyanty, Ab. Rahman, Norhafiza, Lechmiannandan, Abhirrami, Othman, Mohd Yusran, Abdullah, Mohd Yusof
• Format: Conference or Workshop Item
• Language: English
• Published: 2022
• Subjects: R Medicine (General); RD Surgery; RJ Pediatrics
• Online Access: http://irep.iium.edu.my/98235/13/98235_Amyand%E2%80%99s%20hernia%20complicated%20with%20perforated%20appendicitis.pdf; http://irep.iium.edu.my/98235/
• Institution: Universiti Islam Antarabangsa Malaysia

Introduction: Inguinal hernia (IH) is a common condition encountered in premature neonates. Amyand’s hernia (AH) is an uncommon form of IH in which the hernia sac contains appendix. Surgical repair of AH is similar to usual IH, however if it contains a perforated and inflammed appendix, the diagnosis and repair can be challenging. Case summary: A premature baby boy was referred to surgical team for a diagnosis of incarcerated right IH. In view of no obstructive symptoms, he was sent to our out-patient clinic. Upon clinic review irreducible right inguinal hernia was seen clinically with erythematous scrotum and tender. Urgent ultrasound confirmed the diagnosis of IH containing mesentry and bowel. He was brought to theatre urgently concerning bowel compromised. Intra-operatively, a IH was found. However, the appendix was enlarged with evidence of perforation at its tip with surrounding pus collection. Appendicectomy was performed via the same incision followed with herniotomy. He recovered well post-operatively and discharged after three days. Conclusion: Incarcerated IH in neonates without symptoms of intestinal obstruction should raise a suspicion of AH. The presence of inflammation should prompt the possibility of appendicitis or even perforated appendicitis as reported in this case.