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Journal of Case Reports
Amyand’s Hernia in Rohingya Population: A Malaysian Field Hospital Experience
Theeran Gill1, Wazir Azzam1, Tan CL Eugene2, AK Khasnizal3
Departments of 1General Surgery and 2Internal Medicine, Malaysian Field Hospital, Bangladesh; 3Department of General Surgery, Hospital Tawau, Sabah, Malaysia.
Corresponding Author:
Dr. Wazir Azzam
Email: wazirazzam@yahoo.com
Received: 03-JAN-2019 Accepted: 08-MAR-2019 Published Online: 15-MAR-2019
DOI: http://dx.doi.org/10.17659/01.2019.0014
Background: Amyand’s hernia is often difficult to diagnose as it can be confused with a strangulated or an incarcerated inguinal hernia upon presentation where an emergent surgical management is required. Case Report: We present the case of a right Amyand’s hernia on a 65 year old Rohingyan gentleman that presented to our Malaysian Field Hospital with right irreducible inguinal swelling associated with groin pain. He was diagnosed with recurrent right incarcerated inguinal hernia and underwent operation thereafter. Intra-operatively, we identified the presence of chronic scarring and densely adherent segments of the cecum and terminal ileum with a tight external inguinal ring. The appendix appeared grossly normal within the hernial sac. The patient underwent adhesiolysis and the hernia was reduced intra-abdominally which proceeded with a Lichtenstein repair without appendectomy. Conclusion: The incidence of Amyand’s hernia is very rare. Hence the attending surgeon must be vigilant on diagnosing such cases as the mode of operation solely depends on the grade of inflammation of the appendix. 
Keywords : Appendix, Appendectomy, Ileum, Inguinal Hernia, Pain.
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