Amyand's hernia combined with contralateral recurrent inguinal hernia: A case report

INTRODUCTION: Amyand's hernia (AH)—where the appendix becomes incarcerated within the inguinal hernia (IH) sac—is rare, particularly if detected and operated concurrent with a contralateral recurrent IH. PRESENTATION OF CASE: A 65-year-old man presented with symptomatic bilateral IH; the left IH was recurrent. Abdominopelvic computed tomography (CT) revealed a right IH with appendiceal herniation and left recurrent IH with omental fat. Using the prolene hernia system (PHS) mesh, the left recurrent IH underwent operation, followed by the right AH. The patient was in a good state with no recurrence 16 months postsurgery. DISCUSSION: If AH is accidentally encountered during surgery, the procedure should differ depending on the inflammatory state of the appendix. Simultaneously operating AH and contralateral recurrent IH is complicated; it is necessary to preoperatively decide which side to operate on first and whether to use an anterior or laparoscopic posterior surgical approach. If the planned operation is unattainable, alternative surgery should be considered. Fortunately, herein CT was performed prior to surgery, and the surgical plan was properly established. CONCLUSION: Prior to simultaneous AH and contralateral recurrent IH surgery, the surgical plan should be established. If the planned surgical technique for recurrent hernia repair is not feasible, an alternative should be performed. In AH repair, different surgical methods are required depending on the presence and severity of inflammation of the appendix.