THE TRAILING APPENDIX IN A NIGERIAN INFANT: A CASE REPORT AND REVIEW OF LITERATURE.

Abstract

Introduction: Amyand hernia is described as an inguinal hernia in which the hernia sac contains the appendix1. Its incidence is rare, although common in children, and it is often an incidental finding at surgery2,3. While the management widely depends on the Lasanoff and Basson guidelines, the treatment plan, however, remains controversial.

Case presentation: A two-month-old male child with a history of progressively increasing right groin swelling noticed since birth. Examination revealed a right reducible inguinoscrotal swelling, which was separate from the right testis with a positive silk glove sign. A diagnosis of a right reducible inguinoscrotal hernia was made, and he was scheduled for a right herniotomy. Intra-operatively, after reduction of the contents of the hernia sac, the vermiform appendix was seen peeping out of a rent in the wall of the hernia sac. The appendix was returned to the peritoneal cavity, and a Marcy repair was done to complement the herniotomy. The post-operative period was uneventful.

Conclusion: Amyand hernia is a rare clinical condition reported more commonly in children, whose diagnosis remains fortuitous, and the treatment plan, controversial. It is often an intraoperative diagnosis, and the management plan for this condition varies, depending on the status of the appendix at surgery. In large inguinoscrotal hernias in males, we recommend that the content of the sac be examined before transection, and a Marcy's repair should be considered.