The Indian Journal of Pediatrics

, Volume 81, Issue 5, pp 523–523

Vermiform Appendix Inside the Sac: Uncommon Case of Inguinal Hernia

Authors

    • Department of Pediatric SurgeryInstitute for Maternal and Child Health–IRCCS Burlo Garofolo
  • Federica Pederiva
    • Department of Pediatric SurgeryInstitute for Maternal and Child Health–IRCCS Burlo Garofolo
  • Daniela Codrich
    • Department of Pediatric SurgeryInstitute for Maternal and Child Health–IRCCS Burlo Garofolo
  • Jurgen Schleef
    • Department of Pediatric SurgeryInstitute for Maternal and Child Health–IRCCS Burlo Garofolo
Picture of the Month

DOI: 10.1007/s12098-013-1302-6

Cite this article as:
Guida, E., Pederiva, F., Codrich, D. et al. Indian J Pediatr (2014) 81: 523. doi:10.1007/s12098-013-1302-6
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A 2-y-old male, weighting 10 kg, was admitted to authors institute for recurrent swelling in the right groin. No pain, redness or other symptoms were described.

Testicles were scrotal. Suspecting a right inguinal hernia, the authors decided to perform a planned inguinal herniotomy. Two months after the diagnosis, the patient was hospitalized and underwent surgical exploration through a right inguinal incision.

After opening the roof of inguinal canal, hernia sac was identified and the appendix was found inside it. The authors decided not to perform appendectomy, because the appendix was normal (Fig. 1). Therefore they only reduced the appendix into the abdomen and closed the basis of the sac though a biodegradable suture.
https://static-content.springer.com/image/art%3A10.1007%2Fs12098-013-1302-6/MediaObjects/12098_2013_1302_Fig1_HTML.jpg
Fig. 1

Photograph of the normal vermiform appendix on opening of hernia sac

No antibiotic therapy was given. The patient did not require any analgesic therapy after surgery and was discharged the same evening.

On a 6-mo follow-up, no complications were seen.

Amyand’s hernia is defined as an inguinal hernia containing the vermiform appendix [13]. Some authors suggest appendectomy in case of young patients with normal appendix within an inguinal hernia [13]. The authors believe that appendectomy can be avoided in young patients, in case of normal appendix, by simply reducing appendix into the abdomen. Infact, in addition to the immunological function, the possible roles of appendix have been rediscovered today. It has uses in the MACE and Mitrofanoff procedures and has been used in case of ureteral damage and for other reconstructive techniques [47].

Contribution

Jurgen Schleef will act as guarantor for this paper.

Conflict of Interest

None.

Role of Funding Source

None.

Copyright information

© Dr. K C Chaudhuri Foundation 2013