Amyand's Hernia: Report of Two Cases from Irrua, Nigeria

Abstract

Background: Amyand's hernia, a rare form of inguinal hernia in which the hernia sac contains a vermiform appendix, poses diagnostic challenges due to its variable clinical manifestations and nonspecific radiological findings, particularly in low-resource settings. We present two cases of Amyand's hernia, one with acute appendicitis and the other with a normal appendix. Both were managed successfully at Irrua Specialist Teaching Hospital.

Case summary: Both patients presented with irreducible right inguinal or inguinoscrotal swellings, one of which was initially diagnosed as a strangulated hernia. Intraoperatively, the hernia sacs contained the appendix; one was inflamed. Appendicectomy and herniorrhaphy were performed in both cases. Postoperatively, both patients recovered well with no recurrence noted at follow-up.

Conclusion: Amyand's hernia is a rare and unusual condition that requires a high index of suspicion for diagnosis. Surgical exploration with appendicectomy remains the mainstay of treatment. This case series highlights the diverse ways Amyand's hernia can present and emphasizes the importance of early diagnosis and timely surgical intervention. Surgeons should consider Amyand's hernia as a differential diagnosis in patients presenting with irreducible inguinal swellings and tailor treatment to intraoperative findings.