title: A complicated case of amyand's hernia involving a perforated appendix and its management using minimally invasive laparoscopic surgery: A case report.
abstract: BACKGROUND
  Amyand's hernia is a rare condition of inguinal hernia in which the appendix is incarcerated within the hernia sac through the internal ring. Complications include acute appendicitis and perforated appendicitis, which are rare in incidence, accounting for about 0.1% of cases.1These complications prove a diagnostic challenge due to their vague clinical presentation and atypical laboratory and radiological findings. Until recently, open appendectomy was the mainstay of treatment. Laparoscopic surgery offers a less invasive approach to confirming a diagnosis and serving as a therapeutic tool in equivocal cases.
  
  
  METHODS
  We report a case of a previously healthy 20-year-old male presenting with atypical signs and symptoms, as well as blood investigation results, and radiological findings of a perforated appendix within an Amyand's hernia. The patient was successfully managed using a minimally invasive laparoscopic appendectomy approach.
  
  
  CONCLUSIONS
  Until recently, open appendectomy was considered the mainstay in the management of complicated Amyand's hernia. Laparoscopic surgery provides a new avenue for dealing with diagnostic uncertainty with advantages including faster recovery time, reduced hospital stay, and better quality of life.
  
  
  CONCLUSIONS
  This case report highlights the concealing effects of an Amyand's hernia on a perforated appendix, the considerations required when an equivocal diagnosis present and the safe use of the minimally invasive laparoscopic surgery in the treatment of this rare condition.
authors.affiliation: Department of General Surgery, Letterkenny University Hospital, Ireland. Electronic address: w.al-ramli1@nuigalway.ie.
authors.forename: Wisam
authors.initials: W
authors.lastname: Al-Ramli
authors.affiliation: Department of General Surgery, Letterkenny University Hospital, Ireland. Electronic address: yehya832001@yahoo.com.
authors.forename: Yahya
authors.initials: Y
authors.lastname: Khodear
authors.affiliation: Department of General Surgery, Letterkenny University Hospital, Ireland.
authors.forename: Muyiwa
authors.initials: M
authors.lastname: Aremu
authors.affiliation: Department of General Surgery, Letterkenny University Hospital, Ireland.
authors.forename: Abdel Basset
authors.initials: AB
authors.lastname: El-Sayed
keywords: Amyand′s hernia; Appendix complication; Inguinal hernia; Laparoscopic surgery; Minimally invasive surgery; Perforated appendix