Management of Amyand’s hernia in children: should appendectomy be mandatory or not?

Abstract

Background: Amyand’s hernia (AH) is defined as protrusion of the vermiform appendix within the sac of the inguinal hernia and usually misdiagnosed as obstructed hernia. It is more common in pediatric patients but there are controversies about dealing with the normally looking appendix in AH. The aim of this study is to present our experience in the management of AH and highlights the difference in dealing with normally looking appendix between pediatric and adult patients. Patients’ demographics, intraoperative, and postoperative outcome were reported and analyzed. Results: This is a retrospective analysis of 12 pediatric patients aged between 15 days and 5 years presented with AH and operated in tertiary referral hospital over 10 years. This study included 10 males and 2 females. The median age at the operation was 7 months. Eleven patients were operated using conventional technique, and only one patient was operated using laparoscopy. In 11 patients, the appendix was looking normal and was reduced without appendectomy, and the hernia was repaired. Appendectomy was done in one patient presented with AH containing inflamed appendix. The postoperative course was uneventful in all cases. Conclusions: There is a difference in the management of pediatric and adult patients presenting with AH, and appendectomy is not mandatory in normally looking appendix in pediatric patients.