Case Report of A Rare Case of Infantile Amyand's Hernia with Acute Appendicitis Incidentally Found at Elective Herniotomy.

Introduction: Amyand's hernia is the presence of a vermiform appendix in an inguinal hernia sac. It is a rare condition found approximately 1% of the reported cases and even more infrequently about 0.1% reported cases associated with acute or perforated appendicitis. Pre-operative diagnosis is very difficult and most of the cases are encountered during hernia repair. Case presentation: We presented a 1 month old child who was diagnosed to have right reducible inguinal hernia since birth. At his elective right herniotomy we inadvertently found a mildly inflammed tip of vermiform appendix in the inguinal sac. The body and base of appendix was healthy and there was no fluid collection seen. We decided not to remove the appendix and only performed herniotomy for this child. Antibiotics were completed for 1 week, post operatively was uneventful and no complications noted during follow up. Discussion: Amyand's hernia is a very rare disease. In the pediatric age group, computed tomography scan and ultrasound is not commonly practise before the operation, thus its pre-operative clinical diagnosis is very challenging. Treatment includes herniotomy with or without appendectomy depending on the level of inflammation and patient's general condition. Surgeons should be prepared if they encounter an Amyand's hernia especially in the symptomatic inguinal hernia over the right side to ensure that no complications and recurrence occur post operatively. [ABSTRACT FROM AUTHOR]