INTRODUCTION: An Amyand’s hernia is a heterogeneous clinical condition defined by the presence of the vermiform appendix within an inguinal hernia sac, which may or may not contain other abdominal contents or pathologic inflammatory changes. Herein we present an exceptionally rare case of an Amyand’s hernia containing a suppurative appendix and omentum on a morbidity obesity patient , in order to improve our understanding of this disease, avoid misdiagnosis and share experience in the treatment.
PRESENTATION OF CASE: A 46-year-old morbidity obesity male presented to our Emergency Department complained an acute onset abdominal pain near the right groin and the McBurney point with nausea and fever. The patient was initially diagnosed as acute appendicitis according to the laboratory tests and the clinical presentation. However, after a right groin hernia contained an inflamed appendix showed by the computed tomography scan, the final diagnosis of Amyand’s hernia was supported. Surgical treatment was then performed, and a right groin hernia was found to contain a suppurative appendix and omentum, intraoperatively. An appendectomy was performed, but the hernia was not repaired simultaneously considering the morbidity risks and surgically technical difficulty brought with the severe morbidity obesity.
CONCLUSION: With an estimated incidence of only 1%, Amyand’s hernias are rare emergency case, lacking a clear evidence-based management scheme. Moreover, they can contain a diverse range of pathologic features and presentations that can complicate diagnosis and treatment. There is a paucity of reports describing the management of an Amyand’s hernia with appendicitis on morbidity obesity patients. In our case, we shared our surgical experience and the management of Amyand’s hernia on morbidity obesity patient should be tailored to individual’s condition.