外科与临床实践杂志

Strangulated Left-sided Amyand�??s Hernia in an Adult

Vuu SM, DeRogatis MJ, Jimenez TZ, Ramirez CE, Marco Viruez and Gudata Hinika

Amyand’s hernia is a very rare hernia defined as the presence of the vermiform appendix within the inguinal hernia. Few cases of left-sided involvement have been described, and have been mostly been attributed to male children. We present a case of a 76-yearold female who developed peritonitis from a ruptured small bowel proximal to a left-sided Amyand’s hernia. Physical exam showed findings suggestive of a strangulated inguinal hernia on the left, which was confirmed by imaging. The proximal bowel was dilated and ruptured expunging fecal material into the abdomen leading to septic shock. Immediate surgical exploratory laparotomy revealed extensive succus entericus with fecal material throughout abdominal cavity and a strangulated hernia sac in the left inguinal canal consisting of the terminal ileum, cecum, and appendix. The hernia was reduced and repaired, the appendix, terminal ileum and cecum was resected, a stapled ileo-ascending colon anastomosis was performed, and intra-abdominal stool and free fluid were evacuated. Less than twenty cases worldwide of a leftsided Amyand’s hernia have been reported in the literature. To our knowledge, this is the first reported case in the North America of a strangulated left-sided Amyand’s hernia.