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01-10-2020 | Appendicitis | Review

Implications of the presence of the vermiform appendix inside an inguinal hernia (Amyand’s hernia): a systematic review of the literature

Authors: D. Papaconstantinou, Z. Garoufalia, S. Kykalos, C. Nastos, D. Tsapralis, O. Ioannidis, A. Michalinos, G. Chatzimavroudis, D. Schizas

Published in: Hernia | Issue 5/2020

Abstract

Purpose

To identify and sum all available evidence pertaining to the management of Amyand’s hernia (AH).

Methods

A systematic search of the MedLine, Scopus, and Google Scholar databases was performed for studies published until January 2020.

Results

In total, 111 studies incorporating 161 patients were identified, 96 (86.4%) being case reports, 11 (9.9%) case series, and 4 (3.7%) retrospective patient cohorts. Mean patient age was 58.5 ± 19.6 years with 136 (83.9%) being males and 25 (16.1%) females. Furthermore, 149 (92.5%) cases were right-sided hernias while 12 (7.5%) cases were left-sided. Overall, 62.3% of patients presented emergently and 77.3% of patients’ cohort were eventually diagnosed with incarcerated AH. Preoperative diagnosis of AH was established in 23.1% of patients and was achieved either by ultrasound (25%) or CT scan (75%). Operative findings consisted of normal appendix in 73 (45.4%) cases, uncomplicated appendicitis in 62 (38.5%) patients, and perforated appendix in 26 (16.1%). Regarding patients with appendicitis, mesh placement was reported for 17 (21.2%), herniorrhaphy was performed for 51 (63.7%) while 12 (15.1%) patients did not undergo hernia repair during the initial operation. Mesh utilization rates were significantly higher in patients with a normal appendix. Seven cases involved AH containing appendiceal neoplasms. Thirteen cases (8.6%) of postoperative complications were documented and a single case of postoperative death.

Conclusion

AH is a rare type of inguinal hernia usually complicated by appendicitis. Hernia reconstruction should be tailored to each patient individually according to the extent of inguinal canal inflammation.

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Title: Implications of the presence of the vermiform appendix inside an inguinal hernia (Amyand’s hernia): a systematic review of the literature
Authors: D. Papaconstantinou
Z. Garoufalia
S. Kykalos
C. Nastos
D. Tsapralis
O. Ioannidis
A. Michalinos
G. Chatzimavroudis
D. Schizas
Publication date: 01-10-2020
Publisher: Springer Paris
Keywords: Appendicitis
Appendicitis
Inguinal Hernia
Appendectomy
Published in: Hernia / Issue 5/2020
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-020-02215-5

At a glance: The STEP trials

Springer Medicine

Implications of the presence of the vermiform appendix inside an inguinal hernia (Amyand’s hernia): a systematic review of the literature

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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