title: Complicated acute appendicitis within a right inguinal hernia sac (Amyand's hernia): report of a case.
abstract: BACKGROUND
  The term Amyand's hernia refers to a rare clinical situation characterized by the presence of a normal or inflammed appendix within the sac of an inguinal hernia. The situation may be asymptomatic or may present as an incarcerated hernia in case of strangulation or acute appendicitis occurring inside the hernia sac.
  
  
  METHODS
  We present the case of a right Amyand's hernia on a 88-years-old male that presented to our emergency department with a severely tender and swollen inguinal mass that was diagnosed as a strangulated inguinal hernia - inguinal abcess and underwent emergency operation. The intraoperative findings included a severely inflamed and perforated appendix along with healthy part of the caecum inside the sac. Appendectomy with subsequent primary hernia repair without mesh was performed with excellent outcome.
  
  
  CONCLUSIONS
  Because of the fact that most of such rare cases are managed by urgent surgery with no preoperative diagnosis, every surgeon should be prepared for the possibility of coping with such an unexpected situation.
authors.affiliation: Surgical Department "Vostanio" General Hospital, Mytilene, Lesvos Island, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Kouskos
authors.affiliation: Surgical Department "Vostanio" General Hospital, Mytilene, Lesvos Island, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Komaitis
authors.affiliation: Department of Pharmacology, University of Oxford, U.K.
authors.forename: M
authors.initials: M
authors.lastname: Kouskou
authors.affiliation: Department of Pathology, "Vostanio" General Hospital, Mytilene, Lesvos Island, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Despotellis
authors.affiliation: Department of Anesthesiology, "Vostanio" General Hospital, Mytilene, Lesvos Island, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Sanidas
keywords: Inguinal hernia; appendicitis; appendix; hernia mesh