, Volume 12, Issue 3, pp 325–326 | Cite as

Amyand hernia: a classification to improve management

  • J. E. Losanoff
  • M. D. Basson
Letter to the Editor
We read with great interest the recent report by Milanchi and Allins [ 1] on history, imaging, and management of Amyand’s hernia. The authors recommend reduction of the appendix and mesh hernioplasty if there is no acute appendicitis, and appendectomy followed by endogenous repair if an inflamed vermiform appendix is found [ 1]. Although the recommendations of Milanchi and Allins are certainly acceptable, they do not fully reflect the potential variability of clinical scenarios resulting from the four basic types of Amyand’s hernias (Table  1). While the authors’ recommendations apply to Amyand Types I and II, the management of Types III and IV are more complex, and should also be considered.
Table 1

Pathological types of Amyand’s hernia and their respective management

Type of hernia





Salient features

Normal appendix

Acute appendicitis localized in the sac

Acute appendicitis, peritonitis

Acute appendicitis, other abdominal pathology

Surgical management

Reduction or appendectomy...


Diverticulitis Acute Appendicitis Fasciitis Necrotizing Fasciitis Prosthetic Material 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  1. 1.Department of Surgery (11S)John D. Dingell VA Medical CenterDetroitUSA
  2. 2.Department of SurgeryWayne State UniversityDetroitUSA

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