Amyand´s hernia associated with Richter´s hernia evolving with acute appendicitis: case report


  • Hermes Melo Teixeira Batista Faculdade de Medicina do ABC Hospital Regional do Cariri
  • João Antônio Correia FMABC


Amyand´s hernia, Richter´s hernia, appendectomy, Meckel's diverticulum.


Introduction: The presence of vermiform appendix inside the hernia sac is infrequent. In the literature, the reported incidence is of about 1% of all hernias. The finding of acute appendicitis in the inguinal hernia is even rarer, clinical picture that is called Amyand´s hernia. Another possible situation is the Richter´s hernia, where part of the circumference of the intestine is trapped and strangled in the hernia hole, leading to ischemia, gangrene and visceral perforation. We report a case presented at the Hospital Regional do Cariri in Juazeiro do Norte-Ceará, of Amyand´s hernia associated with Richter´s hernia in the same hernia sac, nosological entity of rare occurrence, followed by review of the available literature about the topic. Method: The research was conducted on PubMed using the uniterms "Amyand´s hernia" and "Richter´s hernia" then the most relevant publications about the topic were filtered and correlated with the findings of the case reported. Discussion: In this type of inguinal hernia, the hernia content is constituted by the vermiform appendix concomitant to the antimesenteric pinched edge of the ileal loop. There was still the incidental finding of a Meckel's diverticulum. The patient had a clinical diagnosis of incarcerated hernia and was submitted to surgical treatment with the finding of Amyand´s hernia associated with Richter´s hernia, evolving satisfactorily in the postoperative.

Author Biography

Hermes Melo Teixeira Batista, Faculdade de Medicina do ABC Hospital Regional do Cariri

  1. Laboratory of Study Design and Scientific Writing, ABC Faculty of Medicine. 


Ali SM, Malik KA, Al-Qadhi H. Amyand’s hernia: study of four cases and literature review. SQU Medical Journal. 2012;12:232–36.

Sharma H, Gupta A, Shekhawat NS. Amyand’s hernia: a report of 18 consecutive patients over a 15-year period. Hernia. 2007;11:31–35.

Hutchinson R. Amyand’s hernia. J R Soc Med. 1993;86:104–5.

Llullaku SS, Hyseni NS, Kelmendi BZ, et al. A pin in appendix within Amyand’s hernia in a six-years-old boy: case report and review of literature. World J Emerg Surg. 2010;5:1–3.

Inan I, Myers PO, Hagen ME, et al. Amyand’s hernia: 10 years’ experience. Surgeon. 2009;7:198–202.

Singal R, Gupta S. “Amyand’s Hernia†– Pathophysiology, Role of Investigations and Treatment. A Journal of Clinic Medicine 2011;6(4):321-27.

Breitenstein S, Eisenbach C, Wille G, et al. Incarcerated vermiform appendix in a left-sided inguinal hernia. Hernia. 2005;9:100–2.

Constantine S. Review of literature: computed tomographic appearances of Amyand’s hernia. J Comput Assist Tomogr. 2007;33:359–62.

D’Alia C, Lo Schiavo MG, Tonante A, et al. Amyand’s hernia: case report and review of the literature. Hernia. 2003;7:89–91.

Sarker SK, Jackson K. Laparoscopic extraperitoneal repair of Amyand’s inguinal hernia. JSLS. 2006;10:528–30.

Lyass S, Kim A, Bauer J. Perforated appendicitis within an inguinal hernia: Case report and review of the literature. Am J Gastroenterol. 1997;92:700–2.

Kueper MA, Kirschniak A, Ladurner R. Incarcerated recurrent inguinal hernia with covered and perforated appendicitis and periappendicular abscess: case report and review of the literature. Hernia. 2007;11:189–91.

Ioannidis O, Styliani P, Kakoutis E, et al. Strangulation of the vermiform appendix within a right inguinal hernia: A rare variation of Amyand’s hernia [Letter to the Editor] Am Surg. 2010;76:1305–6.

Francko J, Raftopoulos J, Sulkowski R. A rare variation of Amyand’s hernia. Am J Gastroenterol. 2002;97:2684–85.

Marron CD, Khadim M, McKay D, et al. Amyand’s hernia causing necrotizing fasciitis of the anterior abdominal wall. Hernia. 2005;9:381–83.

Osorio JK, Guzman-Valdivia GG. Ipsilateral Amyand’s and Richter’s hernia, complicated by necrotizing fasciitis. Hernia. 2006;10:443–46.

Burgess P, Brockmeyer JR, Johnson EK. Amyand hernia repaired with Bio-A: a case report and review. J Surg Educ. 2001;68:62–66.






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