title: Left Amyand's hernia: An unexpected finding during inguinal hernia surgery.
abstract: BACKGROUND
  Amyand's hernia is a rare finding of the appendix inside an inguinal hernia sac with classically estimated incidence of 1%. Most cases are found intra-operatively during right-sided inguinal hernia repair.
  
  
  METHODS
  We are reporting a very rare case of left-sided Amyand's hernia. An 81 year-old man with long standing left inguinal hernia was referred to our surgical assessment unit with tender irreducible left inguinal hernia. He was vitally stable with no clinical signs of intestinal obstruction. A diagnosis of irreducible left inguinal hernia without obstruction was made. Exploration of the hernia sac revealed the presence of non-inflamed appendix, caecum and terminal ileum. The contents were reduced and a mesh repair was performed with satisfactorily outcome.
  
  
  CONCLUSIONS
  The surgical management of Amyand's hernia involves appendectomy of inflamed appendix through the inguinal incision together with hernia repair. Prophylactic appendectomy is not recommended by most authors except in young patients.
  
  
  CONCLUSIONS
  There are less than 20 cases reported in the literature describing left-sided Amyand's hernia. Awareness of such very unusual condition may help surgeons to be prepared for appropriate management of a very usual procedure as inguinal hernia repair.
authors.affiliation: Department of Surgery, Sligo regional hospital, Sligo, Ireland. Electronic address: ahmed_azez293@yahoo.com.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Al Maksoud
authors.affiliation: Department of Surgery, Sligo regional hospital, Sligo, Ireland. Electronic address: fatimabitahmed@hotmail.com.
authors.forename: Ahmed Salah
authors.initials: AS
authors.lastname: Ahmed