, Volume 13, Issue 3, pp 335-336
Date: 06 May 2009

The role of prosthetic repair in the treatment of an incarcerated recurrent inguinal hernia with acute appendicitis (inflamed Amyand’s hernia)

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Dear Sir,

We read with considerable interest the paper by Kueper et al. [1], which was referred to the extreme case report of an incarcerated recurrent inguinal hernia with covered and perforated appendicitis which was managed with appendectomy and Bassini operation. The authors concluded that, in a septic environment, the implantation of a prosthetic material should be avoided due to the danger of infection.

We report the second case of an incarcerated recurrent Amyand’s hernia with acute appendicitis, but the first to be successfully treated with appendectomy and polypropylene plug placement at the same time.

A 63-year-old man was admitted to our surgical emergency department with a 12-h history of right lower quadrant pain. Past medical history was unremarkable, with the exception of a right inguinal hernia, repaired with the Shouldice technique 7 years ago. Physical examination showed mild pressure pain in the right lower quadrant of the abdomen without peritoneal irritation. Moreover ...