Amyand: A Forgotten Surgeon And Hernia. Case Presentation And Literature Review.

摘要

The presence of the appendix within inguinal hernia sac is termed Amyand’s hernia. It was first described by Amyand in 1735. We report a case of Amyand's hernia in a 51 years old man mimicking torsion of undescended testis, reviewing the literature and highlighting the great contribution of this genius surgeon to surgical practice. Introduction Amyand was Sergeant Surgeon to King George II. He was the first surgeon to have successfully performed appendectomy in 1735. In spite of his great contribution to surgery, he was ignored in the medical history for long time. Amyand's hernia can be a challenge for the surgeon. Pre-operative diagnosis of hernial appendicitis is very difficult and most of the reported cases were diagnosed preoperatively as incarcerated hernia. We report a case of Amyand’s hernia simulated testicular torsion diagnosed intra operatively Case report A 51 year male, presented to the emergency department of KFMC Riyadh with painful right inguinal swelling. He had this swelling off and on for two years but it suddenly became painful and irreducible for 12 hours before his presentation. He was a known asthmatic and hypertensive on treatment. There was no history of constipation, abdominal distension, vomiting or fever. Examination revealed tender irreducible swelling in the right inguinal region with negative cough impulse. The right scrotum was underdeveloped and empty. Diagnosis of incarcerated right inguinal hernia or torsion of right undescended testis was made on clinical findings. After obtaining informed consent for orchidectomy, the patient was taken for surgical exploration. The inguinal canal was explored under general anesthesia. The hernia sac was found, containing a congested appendix without gross contamination (Figure 1)