Should appendectomy be performed in Amyand’s hernia?: two case reports

The presence of appendix vermiformis in an inguinal hernia sac is called Amyand’s hernia. The disease is named after Claudius Amyand, who performed the first documented and successful appendectomy during a hernioplasty in 1975. Finding an appendix within an inguinal hernia is reported at a rate of 0.51%-1% in the adult population, whereas there is no reported frequency of Amyand’s hernia in children due to its rare occurrence. Here, we report two cases of Amyand’s hernia. The first is a newborn, diagnosed with strangulated Amyand’s hernia by preoperative ultrasound examination of the groin. In this case, the appendix had compromised blood supply, so we performed appendectomy during the hernioplasty. The second patient was diagnosed with Amyand’s hernia during elective hernioplasty. In this case, the appendix had no evidence of circulatory or inflammatory disorders, so we performed simple hernioplasty and left the appendix in the abdominal cavity. In Amyand’s hernia, there are no standards in approaching the appendix. Appendectomy is not a necessity unless there are circulatory or inflammatory injuries.

Amyand fýtýðýnda apendektomi yapýlmalý mýdýr? Ýki olgu sunumu

Fýtýk kesesi içerisinde apendiks vermiformis bulunmasý Amyand hernisi olarak adlandýrýlýr. Hastalýk ismini Ýlk kez 1735 yýlýnda tanýmlayan Claudius Amyand’dan almýþtýr. Yetiþkinlerde görülme sýklýðý %0.51-%1 olarak bildirilmiþ olmasýna raðmen çocuk hasta grubunda olgu azlýðý nedeniyle, bildirilmiþ bir oran bulunmamaktadýr. Bu yazýda ameliyat edilen iki Amyand hernili olgu sunuldu. Birinci olgu yenidoðan döneminde ultrasonografi ile strangüle Amyand hernisi tanýsý konularak ameliyat edildi. Ýkinci olgu, kasýk fýtýðý tanýsý ile elektif þartlarda ameliyat edilirken ameliyat sýrasýnda taný alan hastaydý. Birinci olguda apendiksin dolaþýmýnýn bozulmuþ olduðu görülerek fýtýk onarýmýna ek olarak apendektomi yapýldý. Ýkinci olguda salim bulunan apendiks alýnmadý. Amyand hernisinde apendikse yapýlacak iþlem ile ilgili standart bir yaklaþým yoktur. Apendikste dolaþým bozukluðu gibi komplikasyonlarýn görüldüðü olgular dýþýnda apendektomi yapýlmasý zorunlu deðildir.