Appendicitis within inguinal hernia – case report of a premature newborn with Amyand’s hernia

Abstract

Acute appendicitis within an inguinal hernia is an extremely rare condition among premature newborns with estimated incidence ranging from 0.08% to 0.13%. The diagnosis of this extraordinary entity, known as Amyand’s hernia according to the author who fi rst described it, is often accidental and usually established intraoperatively. We report a case of a boy born at 28 weeks of gestation, who presented with incarcerated right inguinal hernia on his thirty day of life. Surgical intervention was both a diagnostic and therapeutic procedure. Intraoperative diagnosis of Amyand’s hernia was established based on the fi nding of non-perforated, gangrenous appendicitis within the inguinal hernial sac. Appendectomy and hernia repair followed by long-term antibiotic treatment led to complete infant’s recovery. This case report reminds that regardless of its rarity, clinicians should be aware of Amyand’s hernia in the evaluation of incarcerated right side inguinal hernia in preterm newborns.