Amyand's hernia [AH] is a rare condition with presence of vermiform appendix in an inguinal hernia sac [1]. It is a rare entity with very difficult preoperative diagnosis that does not affect management. We herein report a neonatal gangrenous AH masking all features of underlying bowel gangrene. In neonates, a great masquerader can mask all the features of underlying bowel gangrene and delay in diagnosis can be detrimental in context of outcome. A high index of suspicion of Amyand's hernia with gangrene should be kept even if child presents with irreducible hernia without features of strangulation to prevent avoidable increase in morbidity and mortality.
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