Perforated Appendix in Amyand Inguinal Hernia in a Neonate Presenting as Obstructed Oblique Inguinal Hernia: A Case Report and Review of Literature

K. Abdullateef, Youssef Eid, Maryam Aldaqaq, Hassan Marhoon, Sherifa Tawfik, Mohamed Fargaly, Rawan Abdelmaqsoud, M. Kotb, S. Kaddah, H. Taher
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Abstract

: An Amyand hernia is defined as when the appendix is trapped within the sac of an inguinal hernia through a patent vaginal process. It was first described by Claudius Amyand, in 1735 during an appendectomy of a perforated appendix inside a hernial sac of an 11-year old child. Amyand hernia rare, constituting less than 1% of inguinal hernias. Amyand hernia is 3 times more likely to be diagnosed in children compared to adults due to the patency of vaginal process. Appendicitis or its perforation in Amyand hernia, complicate 0.1% of cases. Other variants include the presence of ileum, caecum or both in addition to the appendix. Isolated acute appendicitis in neonates is extremely rare, with a high mortality rate, and higher among those within Amyand hernia up to 30%. Perforated appendix in Amyand hernia is difficult to diagnose, as its clinical picture is not specific. We report a neonate 26 days old with perforated appendix in an Amyand inguinal hernia who presented by a picture of obstructed oblique inguinal hernia. He underwent emergency open inguinal exploration, herniotomy and appendicectomy. Despite the high mortality rate of Amyand hernia due to be peritoneal spread of sepsis, the boy survived complication free. Perforated appendix in Amyand hernia is exceptionally rare, and can present in the early neonatal period, its diagnosis and outcome rely on high index of suspicion and prompt surgical intervention.
新生儿淀粉样腹股沟斜疝阑尾穿孔1例报告及文献复习
Amyand疝的定义是阑尾通过未闭的阴道突被困在腹股沟疝囊内。1735年,克劳迪斯·阿米兰德(Claudius Amyand)在对一名11岁儿童的疝囊内穿孔的阑尾进行阑尾切除术时首次描述了这种疾病。Amyand疝罕见,占腹股沟疝的不到1%。由于阴道过程通畅,儿童Amyand疝的确诊率是成人的3倍。阑尾炎或阑尾炎穿孔在Amyand疝中发生率为0.1%。除阑尾外,还存在回肠、盲肠或两者。孤立性急性阑尾炎在新生儿中极为罕见,死亡率高,在Amyand疝中死亡率更高,可达30%。Amyand疝的阑尾穿孔很难诊断,因为其临床表现不明确。我们报告一个26天大的新生儿,在Amyand腹股沟疝阑尾穿孔,谁提出了梗阻性腹股沟斜疝的图片。他接受了紧急切开腹股沟探查、疝切开术和阑尾切除术。尽管由于脓毒症的腹膜扩散,Amyand疝气的死亡率很高,但这名男孩没有并发症。Amyand疝的阑尾穿孔非常罕见,可出现在新生儿早期,其诊断和预后依赖于高怀疑指数和及时的手术干预。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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