Adults can accidentally swallow foreign bodies (FBs) with food. In rare occasions, these can lodge in the appendix lumen causing inflammation. This is known as foreign body appendicitis. We conducted this study to review different types and management of appendiceal FBs. A comprehensive search on PubMed, MEDLINE, Embase, Cochrane Library and Google Scholar was performed to detect appropriate case reports for this review. Case reports eligible for this review included patients above 18 years of age with all types of FB ingestion causing appendicitis. A total of 64 case reports were deemed to be eligible for inclusion in this systematic review. The patient mean age was 44.3 ± 16.7 years (range, 18-77). Twenty-four foreign bodies were identified in the adult appendix. They were mainly lead shot pellet, fishbone, dental crown or filling, toothpick, and others. Forty-two percent of the included patients presented with classic appendicitis pain, while 17% were asymptomatic. Moreover, the appendix was perforated in 11 patients. Regarding modalities used for diagnosis, computed tomography (CT) scans confirmed the presence of FBs in 59% of cases while X-ray only managed to detect 30%. Almost all of the cases (91%) were treated surgically with appendicectomy and only six were managed conservatively. Overall, lead shot pellets were the most common foreign body found. Fishbone and toothpick accounted for most of the perforated appendix cases. This study concludes that prophylactic appendicectomy is recommended for the management of foreign bodies detected in the appendix, even if the patient is asymptomatic.

Se hace una revisión sobre la introducción en medicina de la cirugía endoscópica ginecológica y la docencia en cirugía laparoscópica, tal cual lo hacemos en nuestra Escuela, cuyos pilares son la anatomía bajo visión laparoscópica, la electrocirugía con sus bases y aplicación, la correcta ergonomía en el quirófano y el manejo correcto de la suturas endoscópicas.

Introduction An Amyand Hernia (AH) is the presence of an Appendix within an Inguinal Hernia. We present here our clinical management of acute appendicitis in an AH and subsequent literature review. A 73-year-old male patient presented with a two-day history of right sided irreducible inguinoscrotal hernia with tender swelling on standing and walking. This was not associated with symptoms of bowel obstruction or fevers. Blood investigations revealed a raised C-Reactive Protein of 129m/l and White Cell Count of 15x10^9/L. A Computed Tomography scan of the Abdomen and Pelvis revealed a right sided inguinoscrotal hernia arising lateral to the inferior epigastric vessels, containing an inflamed appendix and omental fat. The patient underwent an emergency open hernia repair with mesh and, considering that the appendix base was intra-abdominal, also underwent a laparoscopic appendicectomy. Method We conducted a literature review on Pubmed and Medline using the MeSH terms ‘Amyand Hernia’ AND ‘Appendicitis’ from 1970 to 2020. Results We longlisted 179 articles. Of these, 117 were excluded, as they were either paediatric cases, not relevant or mentioned in discussions. Finally, 62 relevant articles were included in the review. Conclusions Acute Appendicitis in Amyand Hernias has an incidence of 0.07-0.13%. Most cases remain as incidental findings however, increased use of imaging techniques has allowed accurate diagnoses and attempts at classifications. There is also weak association with Situs Inversus and atypical appendiceal tumours including adenocarcinoma, carcinoid and neuroendocrine tumour. Their management varies according to the extent of inflammation, radiological and intra-operative findings.

Introduction An Amyand Hernia (AH) is the presence of an Appendix within an Inguinal Hernia. We present here our clinical management of acute appendicitis in an AH and subsequent literature review. A 73 year old male patient presented with a two day history of right sided irreducible inguinoscrotal hernia with tender swelling on standing and walking. This was not associated with symptoms of bowel obstruction or fevers. Blood investigations revealed a raised C-Reactive Protein of 129m/l and White Cell Count of 15x 10^9/L. A Computed Tomography scan of the Abdomen and Pelvis revealed a right sided inguinoscrotal hernia arising lateral to the inferior epigastric vessels, containing an inflamed appendix and omental fat. The patient underwent an emergency open hernia repair with mesh and, considering that the appendix base was intra-abdominal, also underwent a laparoscopic appendicectomy.  Method We conducted a literature review on Pubmed and Medline using the MeSH terms ‘Amyand Hernia’ AND ‘Appendicitis’ from 1970-2020.   Results We longlisted 179 articles. Of these, 117 were excluded, as they were either paediatric cases, not relevant or mentioned in discussions. Finally, 62 relevant articles were included in the review.  Conclusion Acute Appendicitis in Amyand Hernias has an incidence of 0.07-0.13%. Most cases remain as incidental findings however, increased use of imaging techniques has allowed accurate diagnoses and attempts at classifications. There is also weak association with Situs Inversus and atypical appendiceal tumours including adenocarcinoma, carcinoid and neuroendocrine tumour. Their management varies according to the extent of inflammation, radiological and intraoperative findings.