The role of prophylactic appendectomy in amyand’s hernia with non-inflamed appendix in the elderly: A case report

Background: Amyand’s hernia is defined as an inguinal hernia in which a portion of the appendix is found within the hernia sac. The aim of this report is to present a successfully treated case of Amyand’s hernia and to highlight the diagnostic challenges and appropriate surgical considerations. Case Presentation: We present a rare case of a 72-year-old male patient with a 6-year history of enlarging right inguinal hernia. An inguinal examination was remarkable for a right-sided, tender, reducible mass with scrotal involvement. Intraoperatively, the hernia sac was found to contain a non-inflamed appendix. Given the intraoperative findings, the surgical team proceeded with appendectomy followed by herniotomy and mesh repair. The postoperative course was uneventful and the patient was discharged two days after surgery. At follow-up, the patient remained well without evidence of recurrence or obstruction. Discussion: While the incidence of Amyand’s hernia is extremely rare (<1%), it can remain asymptomatic until appendiceal inflammation leads to life-threatening complications such as strangulation, necrosis, or perforation. Our patient had a Type 1 Amyand’s hernia, which typically does not require appendectomy. However, given the patient’s age, overall health status, and surgical risks, we opted for appendectomy to prevent future complications. Successful surgical intervention through appendectomy and hernioplasty emphasizes the importance of an individualized intraoperative approach. Conclusion: This case adds to the limited literature on surgical management of Amyand’s hernia and underscores the need for tailored management depending on the case. Further large-scale studies is needed to establish evidence-based, standardized protocols to ensure optimal outcomes.