Amyand’s hernia is a rare classification of inguinal hernia where the vermiform appendix is located within the hernial sac. This case report discusses a patient presenting with abdominal and groin pain shown to be an Amyand’s hernia complicated by acute appendicitis on computed tomography. The patient was treated with a two-stage approach, involving transabdominal laparoscopic appendectomy and elective laparoscopic hernioplasty after recovery. As some controversy exists regarding the timing of appendectomy and hernioplasty, we examine the benefits of the interval approach in the reduction of postoperative infection risk compared with a concurrent approach in patients presenting with Amyand’s hernia complicated by appendiceal inflammation.

We used a telephone survey to determine risk factors associated with a positive polymerase chain reaction test of a nasopharyngeal swab for severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) at a community hospital in Central New Jersey during the early stages of the pandemic. We compared survey responses of 176 patients in March 2020. Respondents were asked about their living situation, work environment, use of public transportation and attendance at one or more large gatherings (more than 10 people) in the 3 weeks prior to undergoing COVID testing. We found that those who attended a large gathering in the 3 weeks prior to their COVID test had a 2.50 odds ratio (95% CI 1.19, 5.22) of testing positive after controlling for age, sex, race/ethnicity, occupation, living situation and recent visit to a nursing home. The total number of gatherings attended or the number of people in attendance was not associated with a positive test. An association was also seen for specific job types such as factory workers, construction workers, and facilities managers. Attendance at a gathering of more than ten people was associated with testing positive for COVID-19.

BackgroundWhile atraumatic splenic rupture is rare phenomenon, its potential lethality emphasizes its clinical importance. Disseminated neoplastic disease is a known mechanism of atraumatic splenic rupture. Case PresentationThis case report discusses a patient presenting with tension hydrothorax and atraumatic splenic rupture in the setting of non-small cell lung carcinoma requiring emergent chest tube insertion and splenectomy. This patient’s presentation represents only the second documented case of atraumatic splenic rupture secondary to metastatic lung carcinoma without pathological evidence of splenic metastasis. ConclusionsThis unique case emphasizes the importance of assessing structural integrity of the spleen in patients with metastatic non-small cell lung carcinoma, as neoplastic atraumatic splenic rupture conveys a significant mortality risk.