Abstract
Objective: Amyand hernia, defined by the presence of appendix
vermiformis in the inguinal hernia sac, constitutes approximately 1% of the
inguinal hernias. This condition can be determined as acute appendicitis at an
emergency department visit or by incidental preoperative examination. The
safety of using synthetic grafts in the repair of hernia and simultaneous
appendectomy in patients with Amyand hernia is still controversial. In this
study, the results of patients who were diagnosed with Amyand hernia and
underwent surgical treatment in our clinic were evaluated.
Material and Methods: Amyand hernia cases that were followed up and treated between
January 1 and December 31, 2016 were reviewed retrospectively. Demographic data
of the patients, preoperative laboratory tests, radiological examinations,
peroperative treatment approaches and postoperative wound site evaluations were
noted.
Results: All of the patients were male and their mean age was 48
(26-68) years. While elective inguinal hernia operation was planned in 3 of the
patients (42.8%), 4 (57.2%) patients were operated urgently due to incarcerated
right inguinal hernia. Acute appendicitis was present in 3 (75%) of the 4
patients operated due to incarcerated right inguinal hernia, whereas
appendiceal inflammation was not detected in the other patient (25%).
Appendectomy was performed in addition to Lichtenstein procedure with prolene
mesh.
Conclusion: Amyand hernia is a rare condition that is often diagnosed
during surgery. The use of synthetic mesh in hernia repair simultaneous with
appendectomy in a patient with Amyand hernia is safe.
References
- 1. Morales-Cardenas A, Ploneda-Valencia CF, Sainz-Escarrega VH, Hernandez-Campos AC, Navarro-Muniz E, Lopez-Lizarraga CR, et al. Amyand hernia: Case report and review of the literature. Ann Med Surg (Lond). 2015;4(2):113-5.
- 2. Smith-Singares E, Boachie JA, Iglesias IM. A rare case of appendicitis incarcerated in an inguinal hernia. J Surg Case Rep. 2016;2016(6).
- 3. Vehbi H, Agirgun C, Agirgun F, Dogan Y. Preoperative diagnosis of Amyand's hernia by ultrasound and computed tomography. Turk J Emerg Med. 2016;16(2):72-4.
- 4. Michalinos A, Moris D, Vernadakis S. Amyand's hernia: a review. Am J Surg. 2014;207(6):989-95.
- 5. Guler I, Alkan E, Nayman A, Tolu I. Amyand's Hernia: Ultrasonography Findings. J Emerg Med. 2016;50(1):e15-7.
- 6. Cigsar EB, Karadag CA, Dokucu AI. Amyand's hernia: 11years of experience. J Pediatr Surg. 2016;51(8):1327-9.
- 7. Garcia-Cano E, Martinez-Gasperin J, Rosales-Pelaez C, Hernandez-Zamora V, Montiel-Jarquin JA, Franco-Cravioto F. [Amyand's hernia and complicated appendicitis; case presentation and surgical treatment choice]. Cir Cir. 2016;84(1):54-7.
Abstract
Amaç: İnguinal
herni kesesi içinde apendiks vermiformis varlığı ile tanımlanan Amyand herni
inguinal hernilerin yaklaşık %1ini oluşturur. Bu durum akut apandisit tablosu
ile acil servise başvuruya neden olabileceği gibi, perioperatif insidental
olarak da tespit edilebilir. Amyand herni tespit edilen hastalarda
apendektominin yapılıp yapılmaması, apendektomi yapılınca fıtık onarımında
sentetik greft kullanımının güvenirliği halen tartışma konusudur. Bu çalışmada
kliniğimizde Amyand herni tanısı konulan ve cerrahi tedavisi yapılan hastaların
sonuçları bildirilmiştir.
Gereç ve Yöntem:
1
Ocak 2016 ile 31 Aralık 2016 tarihleri arasında takip ve tedavisi yapılan
Amyand herni olguları retrospektif olarak incelenmiştir. Hastaların demografik
verileri, preoperatif laboratuvar testleri ve radyolojik incelemeleri,
peroperatif tedavi yaklaşımları, postoperatif yara yeri değerlendirmeleri not
edildi.
Bulgular: Hastaların
tamamının erkek cinsiyet olduğu görüldü. Hastaların ortalama yaşı 48 (26-68
yıl) olarak bulundu. Hastaların 3’üne (%42.8) elektif inguinal herni operasyonu
planlanırken 4’ü (%57.2) inkarsere sağ inguinal herni nedeni ile acil ameliyat
edilmiştir. İnkarsere sağ inguinal herni tanısı ile ameliyat edilen 4 hastanın
3’ünde (%75) akut apandisit tablosu mevcut iken diğer bir hastada (%25)
apendiks enflamasyonu tespit edilmedi. Tüm hastalara herniorafiye ek olarak
apendektomi uygulanırken, herni onarımı Lichtenstein prosedürü ile prolen mesh
tespiti yöntemi ile yapıldığı görüldü.
Sonuç: Amyand herni
oldukça nadir görülen, sıklıkla operasyon sırasında tanı alan bir durumdur.
Amyand herni tespit edilen hastada herni onarımına apendektominin eklenmesi ve
herniorafide sentetik mesh kullanımı güvenlidir.
References
- 1. Morales-Cardenas A, Ploneda-Valencia CF, Sainz-Escarrega VH, Hernandez-Campos AC, Navarro-Muniz E, Lopez-Lizarraga CR, et al. Amyand hernia: Case report and review of the literature. Ann Med Surg (Lond). 2015;4(2):113-5.
- 2. Smith-Singares E, Boachie JA, Iglesias IM. A rare case of appendicitis incarcerated in an inguinal hernia. J Surg Case Rep. 2016;2016(6).
- 3. Vehbi H, Agirgun C, Agirgun F, Dogan Y. Preoperative diagnosis of Amyand's hernia by ultrasound and computed tomography. Turk J Emerg Med. 2016;16(2):72-4.
- 4. Michalinos A, Moris D, Vernadakis S. Amyand's hernia: a review. Am J Surg. 2014;207(6):989-95.
- 5. Guler I, Alkan E, Nayman A, Tolu I. Amyand's Hernia: Ultrasonography Findings. J Emerg Med. 2016;50(1):e15-7.
- 6. Cigsar EB, Karadag CA, Dokucu AI. Amyand's hernia: 11years of experience. J Pediatr Surg. 2016;51(8):1327-9.
- 7. Garcia-Cano E, Martinez-Gasperin J, Rosales-Pelaez C, Hernandez-Zamora V, Montiel-Jarquin JA, Franco-Cravioto F. [Amyand's hernia and complicated appendicitis; case presentation and surgical treatment choice]. Cir Cir. 2016;84(1):54-7.
Details
| Subjects | Health Care Administration |
|---|---|
| Journal Section | Articles |
| Authors | |
| Publication Date | December 18, 2017 |
| Submission Date | August 12, 2017 |
| Published in Issue | Year 2017 Volume: 19 Issue: 3 |
Cite
Bu Dergi, Kırıkkale Üniversitesi Tıp Fakültesi Yayınıdır.