Totally Laparoscopic Repair of an Acutely Inflammed Amyand’s Hernia

Amyand’s hernia – the presence of appendix within an inguinal hernia sac poses a diagnostic and therapeutic challenge in the acute setting. We report the case of a female patient on long-term corticosteroid therapy that was found at laparoscopy to have an inflamed appendix incarcerated within a right inguinal hernia. A 62-year-old Caucasian female presented with a short history of sudden-onset pain in the right groin. Her past medical history included polymyalgia rheumatic for which she had been treated over the past 4 years with oral prednisolone. The studied case was successfully treated through laparoscopic appendectomy and laparoscopic suturing of the deep inguinal ring. This totally laparoscopic approach may be of use in cases where definitive treatment with mesh cannot be undertaken and the avoidance of large wounds is desirable.