title: Left inguinal appendix in an HIV patient: A case report and review of literature.
abstract: BACKGROUND
  The presence of the appendix in an inguinal hernia sac is rare, with an estimated incidence of 0.51-1% of all inguinal hernias. An inguinal appendix is most commonly referred to as Amyand's hernia.
  
  
  METHODS
  A 59-year-old HIV positive male presented to our center with a left painful inguinal mass. The preoperative diagnosis was a left inguinal hernia. Intraoperatively, the sac was found to contain a non inflamed appendix; the appendix was reduced back to the peritoneal cavity and the patient underwent a tension free prosthetic left inguinal hernia repair.
  
  
  CONCLUSIONS
  Most cases of inguinal appendices are right-sided and are diagnosed intraoperatively; left-sided cases as we encountered are rare and most likely the result of cecal mobility. Preoperative diagnosis of the entity is difficult and most cases are diagnosed intraoperatively. A CT scan is not necessary unless other pressing differentials need to be ruled out. Most authors agree that if the appendix is not inflamed, appendectomy, concurrently with herniorrhaphy, should not be performed to avoid perioperative septic complications.
  
  
  CONCLUSIONS
  Surgical management of inguinal appendices carries a risk of septic complications. This is especially pertinent to our case, considering the immunocompromised status of our patient. The decisions in the operating room were geared toward limiting septic potential.
authors: The Brooklyn Hospital Center, Department of Surgery, 121 DeKalb Ave., Brooklyn, NY 11201, United States. Electronic address: noubar.kevorkian@gmail.com.
authors: Noubar
authors: N
authors: Kevorkian
authors: Chad
authors: C
authors: Rennie
authors: Armand
authors: A
authors: Asarian
authors: Peter
authors: P
authors: Pappas
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