A Case of Amyand's Hernia Occurred in a Patient with Myelodysplastic Syndrome

Takehiro Sakai, Koichi Sato, Hiroshi Ogasawara, Yasuhiro Sudo, Masashi Koyanagi and Masanori Tanaka*

Department of Surgery and Department of Pathology and Laboratory Medicine*, Hirosaki City Hospital

A 67-year-old Japanese man with myelodysplastic syndrome admitted for right inguinal swelling and pain and diagnosed with incarceration of a right inguinal hernia was found to have an irreducible round 3.5-cm mass with tenderness. Laboratory findings indicated pancytopenia, necessitating emergency surgery under general anesthesia. The patient was diagnosed with right external inguinal hernia. The hernia sac contained the vermiform appendix. The apex of the vermiform appendix was dark red and evidenced apparent ischemic change due to strangulation. We conducted appendectomy and hernioplasty using a mesh plug. Pathological examination showed erosion in the mucosa and severe serositis at the incarcerated portion of the apex of the vermiform appendix. The postoperative course was uneventful and the patient was discharged on postoperative day 8. Inguinal hernia containing the vermiform appendix, known as Amyand's hernia, is relatively rare. Despite the high risk of infection due to myelodysplastic syndrome, our patient was successfully treated without wound infection.

Key words
inguinal hernia, vermiform appendix, myelodysplastic syndrome

Reprint requests
Takehiro Sakai Department of Surgery, Hirosaki City Hospital
3-8-1 O-machi, Hirosaki, 036-8004 JAPAN

Accepted
November 22, 2006

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