Inflamed Right Inguinal Appendix in a Sixty-four-year-old Man: A Case Report and Review of the Literature

Abstract

The vermiform appendix has varied locations ranging from retrocaecal, pelvic, paracolic to pre-ileal and postileal. Inguinal appendix or Amyand’s hernia is an extremely rare occurrence with potentially fatal complications. Rarer still is the presence of an inflamed appendix in the inguinal canal in the elderly. Due to its rarity, the pathophysiology and risk factors of the condition are still unclear. Some theorize that it is secondary to a patent processus vaginalis or perhaps the presence of a fibrous band between the hernia sac and testes.  Reported herein is a 64-year-old man who presented with a painful irreducible right inguinal swelling. An incarcerated inguinal hernia with the hernia sac harbouring an inflamed vermiform appendix was discovered at surgery. Appendectomy and a primary suture repair of the hernia were carried out. The postoperative period was uneventful. Surgical management of inflamed inguinal appendix carries a risk of septic complications. It is pertinent that every surgeon performing a hernia repair must be aware of this condition and the appropriate treatment modalities.