Preoperative diagnosis of Amyand's hernia complicated by strangulated acute appendicitis: a case report and literature review.

Abstract

Amyand's hernia (AH) is a rare clinical entity characterized by the presence of the appendix within an inguinal hernia sac, with or without associated appendicitis, and is rarely diagnosed preoperatively due to its nonspecific clinical presentation. We report the case of a 66-year-old woman who presented with an irreducible right inguinal swelling accompanied by severe right lower abdominal pain. Contrast-enhanced computed tomography (CT) revealed an inflamed appendix within the hernial sac, consistent with a strangulated AH. The patient underwent appendectomy along with hernia repair, with an uneventful postoperative recovery. Although acute appendicitis within an AH is typically identified intraoperatively, advances in imaging (particularly CT scanning) allow accurate preoperative diagnosis and facilitate appropriate surgical planning. Management should be tailored according to Losanoff and Basson's classification, with appendectomy and hernia repair being an effective approach for type II AH cases.