title: "Amyand's Hernia" - Pathophysiology, Role of Investigations and Treatment.
abstract: BACKGROUND
  In the present era, appendicitis and hernia are common problems but their presentations in different positions are rare to be seen. It is difficult to make diagnose pre-operatively of contents as appendicitis in obstructed hernia. The term "Amyand's hernia" was lost in the literature and we are describing its pathophysiology and management. The aggravating factors are: complex injuries related to hernia (size, degree of sliding, multiplicity, etc.), patient characteristics (age, activity, respiratory disease, dysuria, obesity, constipation). If not treated in the earliest stages then it can lead to significant morbidity and mortality. Existing literature describes almost exclusively its pathophysiology, investigations and treatment.
  
  
  METHODS
  We have focused on clinical presentation, radiological investigations and management of "Amyand's hernia". In literature, there is still confusion regarding investigations and treatment. We are presenting such rare entity managed in time without encountering any post-operative complications.
  
  
  RESULTS
  Ultrasonography and Computed Tomography are useful tests but clinical correlation is necessary in incarcerated appendix. Regarding treatment, it is clear that if appendix is inflamed then it should be removed, but we concluded that if appendix is found to be normal in obstructed hernia then it should also be removed due to possible later inflammation.
  
  
  CONCLUSIONS
  If the appendix found in the hernial sac is inflamed then chances of mortality increase. Although emergency surgery is indicated in all obstructed hernias, morbidity and mortality can be decreased if operated on time. Early recognition and its awareness, along with good surgical technique in such cases are keys to success when dealing with this problem.
authors.affiliation: MBBS, MS, FICS, FAIS (Assistant Prof.), Department of Surgery, Maharishi Markandeshwer Institute of Medical Sciences and Research, Mullana, Distt-Ambala, India.
authors.forename: Rikki
authors.initials: R
authors.lastname: Singal
authors.forename: Samita
authors.initials: S
authors.lastname: Gupta