A CASE OF AMYAND'S HERNIA DURING CHEMOTHERAPY

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  • Ａｍｙａｎｄ’ｓ　ｈｅｒｎｉａの１例

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Abstract

A 69-year-old man was diagnosed as having sigmoid colon cancer with multiple liver metastases at our hospital on September 26, 2007, and was started on chemotherapy. He had suffered from right lower abdominal pain since April 2, 2008. He underwent an examination at our hospital for the pain aggravated on April 10, 2008, and was found to have inguinal induration and tenderness. He was diagnosed as having incarceration of inguinal hernia by an abdominal CT scan, followed by an emergency operation. There was intraoperative evidence that an egg-sized hernia sac was adhered to the thickened spermatic cord. When incised cord-like structure continuing to the abdominal cavity, accompanied by yellow-green cloudy pus and marked inflammation were found. Partial incision revealed necrotized mucosa with hernia contents consisting of the vermiform appendix. It was impossible to release the dense adhesions between the hernia sac and the vermiform appendix, therefore together with the hernia sac the root of the appendix was double-ligated and cut off. Iliopubic tract repair was used for the repair. An inguinal hernia in which the content consists of an incarcerated vermiform appendix is extremely rare, called Amyand's Hernia. This case is reported with some reriew of literatures.

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