Amyand's Hernia and the Desarda Repair: A Case Series and Contemporary Review of Management Strategies.

Abstract

Treatment guidelines regarding appendix-containing groin hernias lack clarity with respect to tissue versus mesh repair in cases that are considered clean-contaminated following appendectomy. We review the management of Amyand's hernia based on currently available literature and describe the cases of three adult male patients who underwent operative repair of Amyand's hernias. Case 1 involves a 64-year-old man who underwent Desarda tissue repair and appendectomy for intraoperatively discovered appendicitis. Case 2 involves a 48-year-old man who underwent appendectomy and Desarda tissue repair due to an ischemic appendix. Case 3 involves a 71-year-old man with a complex cardiac history who underwent open Lichtenstein repair with absorbable biosynthetic mesh following ileocecectomy for cecal ischemia. These cases are discussed in the context of current management guidelines and published literature regarding tissue repair versus mesh placement and the role of appendectomy. Most available literature supports appendectomy and tissue repair in cases of appendicitis or contamination. However, individualized patient factors, including anatomy, contamination risk, and recurrence risk, should guide the choice of repair technique.