A Silent Intruder: A Case of Asymptomatic Appendix in a Chronic Right Inguinoscrotal Amyand’s Hernia

TL;DR

A 60-year-old man had a rare case of Amyand’s hernia, where an asymptomatic appendix was found inside a long-standing inguinal hernia and successfully treated with surgery.

Contribution

This case highlights the importance of surgical exploration in diagnosing rare intraoperative findings like Amyand’s hernia.

Findings

An asymptomatic appendix was found inside a chronic inguinoscrotal hernia during surgery.

Histopathology confirmed the appendix was normal with no inflammation.

The case emphasizes the need for thorough surgical evaluation of inguinal hernias.

Abstract

Amyand's hernia is accidentally seen through the surgical exploration of an appendix herniation within an inguinal hernia sac. A 60-year-old patient in the case received medical attention for his painless right inguinoscrotal swelling that had been present for 18 years. Clinical examination of the swelling showed reducible swelling with a positive cough impulse. The preoperative ultrasound showed that omentum existed inside the hernia sac. The surgical procedure showed that an asymptomatic appendix was located in the hernia region, thus confirming an Amyand’s hernia diagnosis. Appendectomy, as well as mesh repair during hernioplasty, was performed. Histopathological analysis also confirmed that the appendix had a typical appearance without signs of inflammation. After being discharged from the hospital, the patient experienced a smooth recovery period requiring regular follow-ups with the healthcare team. The given case of Amyand’s hernia shows that proper diagnosis remains challenging, but one must perform surgical exploration on inguinal hernias since rare findings such as Amyand’s hernia are typically diagnosed intraoperatively. Although it is rare, the diagnosis of such conditions is also essential for appropriate surgical management for improving outcomes in patients.

Figures