# Left-Sided Amyand’s Hernia Managed Without Appendectomy: A Case Report of a Rare Diagnosis

## TL;DR

A rare case of left-sided Amyand’s hernia in a 45-year-old patient is reported, highlighting the importance of early diagnosis and management to avoid complications.

## Contribution

This case report presents a rare left-sided Amyand’s hernia managed without appendectomy, emphasizing clinical management in resource-limited settings.

## Key findings

- A 45-year-old patient presented with a long-standing left-sided Amyand’s hernia that could not be manually reduced.
- The case highlights the risks of delayed treatment, including incarceration and peritonitis, common in regions with limited healthcare access.
- Early diagnosis and individualized management are critical to reduce complications in such hernia cases.

## Abstract

Hernias are defined as protrusions of an organ or its fascia through the wall of a cavity. Amyand's hernia, in turn, is a rare subtype in which the vermiform appendix is part of the hernial content. We report the case of a 45-year-old Angolan patient with a large left-sided Amyand’s hernia, which appeared in childhood at the age of 5, with progressive enlargement and an inability to manually reduce the contents for the past seven years. He was referred from the Hospital Militar Principal/Instituto Superior in Luanda, Angola. Large inguinoscrotal hernias remain frequent in African countries, often associated with limited access to, or late-seeking of, healthcare services. Delayed management of these patients is linked to an increased risk of preoperative complications, such as incarceration, strangulation, appendicitis, and perforation-induced peritonitis, as well as postoperative complications, including abdominal compartment syndrome. Therefore, early diagnosis and individualized patient management - considering age and comorbidities, especially in the early stages - are of utmost importance for effective and less traumatic correction.