AMYAND'S INGUINOSCROTAL TYPE 2 HERNIA WITH ACUTE APPENDICITIS: A CASE REPORT (Atena Editora)

Abstract

Amyand's hernia was first described by Claudius Amyand, in 1786. It is defined as the presence of the ileocecal appendix, inflamed or not, inside an inguinal hernia. The incidence of this pathology associated with acute appendicitis is rare and ranges from 0.13 to 0.07% among inguinal hernias. This report describes the case of a patient who was admitted to the emergency room with a picture suggestive of acute scrotum, with complaints of severe pain in the inguinal region, associated with difficulty in mobilizing the ipsilateral lower limb, volumetric increase in the right testicle. After performing an imaging exam, which indicated the presence of the ileocecal appendix inside the hernial sac in the inguino-scrotal region, a rare condition called Amyand's Hernia was diagnosed. The patient underwent infraumbilical median laparotomy, and it was possible to identify the inguino-scrotal hernia and the inflammation of the vermiform appendix. Appendectomy was performed, followed by closure of the hernia sac. Lower midline laparotomy is the choice for diagnosis and treatment, but imaging tests can help identify the presence of such pathology. Physical examination is also an important ally, but has limitations, since the presentation of appendicitis is atypical, as there may be no presence of painful sensitivity at McBurney's point and the abdomen may be free of alterations associated with peritoneal irritation. In general, the main finding is the presence of irreducible bulging in the inguinal or testicular region. The objective of this report is to present a case report of Amyand's Hernia, associated with acute appendicitis and to demonstrate the importance of early diagnosis and adequate treatment of this condition, in order to avoid serious complications in the patient's life, such as peritonitis, acute abdomen and sepsis.