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Perforated Amyand hernia with an adenocarcinoma tumour presenting as a groin abscess

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Peer-reviewed

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Authors

Miremadi, Ahmad 

Abstract

An Amyand hernia is an incarcerated inguinal hernia containing the appendix with or without appendicitis. This is a rare form of inguinal hernia, making up approximately 0.4%-1% of all cases. As with any hernia, this may become strangulated at any time, leading to the loss of blood supply and further development of gangrene and complications. Clinically, this can present in a manner indistinguishable from other types of inguinal hernias. In addition, the appendix can be affected by its own set of pathological processes, such as infection, inflammation, and malignancy. Not uncommonly both hernial and appendiceal complications coexist. The clinical diagnosis of an Amyand hernia remains challenging due to its low incidence and indistinct clinical presentation. At present, surgery is usually diagnostic and therapeutic. However, there is a growing number of recent reports showing the invaluable role of imaging on the diagnosis of Amyand hernias and associated complications. The correct and timely recognition of their imaging features including complications can optimize and expedite patient care by guiding diagnosis, treatment, and prognosis. Here, we report for the first time the radiological and pathological findings of a patient with a unique complicated Amyand hernia, which posed a diagnostic challenge for the clinical and radiological teams.

Description

Acknowledgements: The authors acknowledge support from National Institute of Health Research Cambridge Biomedical Research Centre, Cancer Research UK (Cambridge Imaging Centre grant number C197/A16465), the Engineering and Physical Sciences Research Council Imaging Centre in Cambridge, and Manchester and the Cambridge Experimental Cancer Medicine Centre.


Funder: National Institute of Health Research Cambridge Biomedical Research Centre


Funder: Cancer Research UK; DOI: https://doi.org/10.13039/501100000289


Funder: Engineering and Physical Sciences Research Council Imaging Centre in Cambridge


Funder: Manchester and the Cambridge Experimental Cancer Medicine Centre


Funder: Academy of Medical Sciences; DOI: https://doi.org/10.13039/501100000691


Funder: Wellcome Trust; DOI: https://doi.org/10.13039/100010269


Funder: Medical Research Council; DOI: https://doi.org/10.13039/501100000265


Funder: British Heart Foundation; DOI: https://doi.org/10.13039/501100000274


Funder: Versus Arthritis; DOI: https://doi.org/10.13039/501100012041


Funder: Diabetes UK; DOI: https://doi.org/10.13039/501100000361


Funder: British Thoracic Society; DOI: https://doi.org/10.13039/501100000574

Keywords

Amyand hernia, abscess, hernia, ultrasound, adenocarcinoma, CT, appendicitis, perforation

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Publisher

Oxford University Press
Sponsorship
Cambridge Imaging Centre (C197/A16465)
National Institute for Health and Care Research (NIHR CL-2017-14-502)
Helen and Andrew Douglas bequest (SGL019\1007)