Use of an open double incision to treat acute appendicitis in an Amyand’s hernia: a case report and review of the literature

Amyand’s hernia (AH) is an inguinal hernia that contains the vermiform appendix within its sac and is difficult to diagnose preoperatively. We encountered a case of AH with acute perforated appendicitis and peritonitis, which was diagnosed based on preoperative CT. Intraoperatively, we discovered that the internal inguinal ring was small, and part of the appendix was within the hernia sac; the proximal end of the appendix was intra-abdominal, and the fascia transversalis was intact. We used a unique double-incision approach for the surgery with inguinal and McBurney’s incisions. Via the inguinal incision, we probed the appendix and repaired the hernia using the Bassini technique rather than the Shouldice technique. The appendectomy was performed and the purulent intra-abdominal secretions were cleaned via the McBurney incision. Outcomes for this patient were ideal. We also reviewed the related literature and analyzed recent reports on AH.