Amyand hernia with acute appendicitis in a patient with ambiguous genitalia: A case report

Abstract

Introduction

Inguinal hernia is a common condition in children. pathology. An Amyand hernia is defined as an inguinal hernia that contains the vermiform appendix. The occurrence of acute appendicitis in the context of an Amyand hernia is uncommon, and the diagnosis can be difficult in patient with abnormal genitalia.

Case presentation

The patient was a 1-year-old male diagnosed at birth with ambiguous genitalia and androgen insensitivity syndrome. His scrotal sac resembled labia majora. He underwent a complete genetic diagnosis which showed 46 XY heterozygous karyotype. He also had penoscrotal hypospadias. He had no history of prenatal conditions. There were no genetic diseases in his family. He was brought to the emergency room with an enlarged edematous right hemi-scrotum and painless erythema. He had a 3 × 3 cm painless mass with edema and erythema simulating an acute scrotum. An ultrasound was done and showed a right inguinal hernia containing omentum and bowel loops. He was taken to the operating room for an exploratory laparoscopy. We found that the appendix was partially herniated into the right inguinal canal. When we pulled it back into the abdomen, we noticed that the tip was inflamed. We did an appendectomy and closed the hernia with a non-absorbable suture. Following this, we did a trans-scrotal right orchidopexy. He recovered well from the operation ad has been doing well in all follow up visits.

Conclusion

Amyand hernia with inflammation of the appendix must be considered in children who present acute redness of the inguinal canal and external genitalia.