title: Perforated appendix and periappendicular abscess within an inguinal hernia.
abstract: We report an extremely rare case of complicated Amyand's hernia. A 61-year-old male patient was admitted with clinical signs of incarcerated right inguinal hernia and localised tenderness in the right iliac fossa. He underwent emergency surgery and the operative findings included perforated appendix and periappendicular abscess within a right inguinal hernia sac. Appendectomy and Shouldice's herniorrhaphy without prosthetic mesh placement were performed. Histology revealed the presence of a villous adenoma near the base of the appendix. We point out that although Amyand's hernia is a very rare clinical entity, it should always be considered in the differential diagnosis in cases with clinical signs of incarcerated right inguinal hernia, especially when there are no pathological findings on the abdominal X-rays.
authors.affiliation: 2nd Department of Surgery, 417 Army Veterans General Hospital NIMTS, 10-12 Monis Petraki str, 11521 Kolonaki, Athens, Greece. nikos_salemis@hotmail.com
authors.forename: N S
authors.initials: NS
authors.lastname: Salemis
authors.forename: K
authors.initials: K
authors.lastname: Nisotakis
authors.forename: K
authors.initials: K
authors.lastname: Nazos
authors.forename: P
authors.initials: P
authors.lastname: Stavrinou
authors.forename: E
authors.initials: E
authors.lastname: Tsohataridis
mesh_terms: D018784:Abdominal Abscess / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D001064:Appendicitis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D003937:Diagnosis, Differential; D013505:Digestive System Surgical Procedures / Q000379:methods; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous