HERNIA AMYAND - O ENTITATE ANATOMOCLINICÃ RARÃ DIAGNOSTICATÃ INTRAOPERATOR

The Amyand hernia is an uncommon variant of the inguinalhernia, rarely recognised before the surgical treatment because of the confusion with a strangledhernia. In spite of this, the clinical presentation seems to follow a well determined pathway, soit is possible to state that the uncorrect diagnosis is to be attributed to the ignorance of thisvariant of hernia. We present two consecutive case reports of acute appendicitis founded in aninguinal hernia sac. The clinical presentation depended on the inflammation extension inside thehernia sac and the presence or not of peritoneal contamination. The patients were admitted fora painful pseudotumor in the inguinal region with irreducibility, mimicking strangled inguinalhernia with acute inflammatory syndrome. Intraoperatively we have found a hernia sac with aphlegmonous/gangrenous appendix inside. Appendectomy was performed, followed by hernioplasty(retrofunicular technique) without prosthetic material). The operation followings werefavorable. We conclude that amyand hernia must be considered as differential diagnosis ofapparently strangled inguinal hernias. Technical precautions and antibioprophylaxy appliedduring surgery may prevent septic complications after hernioplasty. The hernia repair must beperformed without prosthetic material and using exclusively resorbable sutures.