title: [Amyand's hernia and complicated appendicitis; case presentation and surgical treatment choice].
abstract: BACKGROUND
  A caecal appendix within an inguinal hernia, with or without appendicitis, is defined as Amyand's hernia. In 1% of inguinal hernias an appendix without inflammation can be found, however, the prevalence of appendicitis in a hernia sac is only 0.08-0.13%.
  
  
  METHODS
  Male of 43 years old, began two days before admission with pain in the right inguinal region. He was scheduled for surgery due to a complication of a right inguinal hernia. The surgical findings were Amyand's hernia, necrotic spermatic cord, and perforated appendix. Surgical repair was performed with a favourable outcome, and he was discharged on the fourth postoperative day.
  
  
  CONCLUSIONS
  Most of Amyand's hernia exhibit characteristics of incarcerated or strangulated inguinal hernia. Even acute appendicitis or perforated appendix within the hernia sac does not reflect specific symptoms or signs, therefore, a preoperative clinical diagnosis of Amyand's hernia is difficult to achieve. In our case, the patient had perforated appendicitis, developing necrosis of the spermatic cord. Orchiectomy, appendectomy, and inguinal hernia repair was performed without placing mesh. Due to the controversy on the use of mesh in contaminated abdominal wall defects, it was not indicated here, due to the high risk of wound infection and appendicular fistula.
  
  
  CONCLUSIONS
  An extremely rare condition is presented, with a surgical choice that led to a favourable outcome.
authors.affiliation: Servicio de Cirugía General, Unidad Médica de Alta Especialidad, Instituto Mexicano del Seguro Social, Puebla, Puebla, México. Electronic address: eugenio_g_c@hotmail.com.
authors.forename: Eugenio
authors.initials: E
authors.lastname: García-Cano
authors.affiliation: Servicio de Cirugía General, Unidad Médica de Alta Especialidad, Instituto Mexicano del Seguro Social, Puebla, Puebla, México.
authors.forename: José
authors.initials: J
authors.lastname: Martínez-Gasperin
authors.affiliation: Servicio Cirugía General, Hospital Regional Número 36, Instituto Mexicano del Seguro Social , Puebla, Puebla, México.
authors.forename: César
authors.initials: C
authors.lastname: Rosales-Pelaez
authors.affiliation: Universidad Popular Autónoma del Estado de Puebla, Puebla, Puebla, México.
authors.forename: Valeria
authors.initials: V
authors.lastname: Hernández-Zamora
authors.affiliation: Unidad Médica de Alta Especialidad, Hospital de Traumatología y Ortopedía, Instituto Mexicano del Seguro Social, Puebla, Puebla, México.
authors.forename: José Álvaro
authors.initials: JÁ
authors.lastname: Montiel-Jarquín
authors.affiliation: Servicio Cirugía General, Hospital Regional Número 36, Instituto Mexicano del Seguro Social , Puebla, Puebla, México.
authors.forename: Fernando
authors.initials: F
authors.lastname: Franco-Cravioto
mesh_terms: D000328:Adult; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000150:complications* / Q000601:surgery; D000075202:Contraindications; D004322:Drainage; D006552:Hernia, Inguinal / Q000150:complications* / Q000601:surgery; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007511:Ischemia / Q000209:etiology; D008297:Male; D009336:Necrosis; D009919:Orchiectomy / Q000379:methods*; D013085:Spermatic Cord / Q000098:blood supply / Q000473:pathology / Q000601:surgery; D013526:Surgical Mesh; D013530:Surgical Wound Infection / Q000517:prevention & control; D013536:Suture Techniques
keywords: Amyand's hernia; Apendicitis complicada; Complicated appendicitis; Hernia Amyand; Surgical treatment; Tratamiento quirúrgico