Presentation
A patient presented with RLQ pain and right inguinal lump for the past few days. No previous malignant history.
Patient Data
CT reveals a right inguinal hernia containing appendix (Amyand hernia) with dilated lumen, diffuse wall thickening and enhancement, periappendicular inflammatory changes and fluid within hernial sac.
There is also left sided inguinal hernia containing intrabdominal fat within hernial sac.
Findings are most suggestive of Amyand hernia with complicated appendicitis.
Case Discussion
Patient underwent surgery. Surgery confirms Amyand hernia and acutely inflamed appendix within right inguinal canal. Histopathological review of the appendix confirmed acute suppurative appendicitis.
Amyand hernias are an uncommon form of inguinal hernia and see in less than 1% of inguinal hernias. Appendicitis within an Amyand’s hernia is a very rare entity and is usually due to incarceration from edema at the internal ring or contraction of the abdominal muscles at the inguinal canal.
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