Inguinal hernias are the most prevalent type of abdominal wall hernia. While many cases are uncomplicated, some variant forms can pose a heightened risk of severe complications. We report the case of a 46-year-old male who arrived at the emergency department with a two-day history of diffuse abdominal pain, with an otherwise negative review of systems, an unremarkable medical and surgical history, and normal laboratory results. The physical examination revealed a palpable, non-reducible mass in the right groin, raising suspicion of an inguinal hernia. A CT scan of the abdomen and pelvis was conducted, confirming Amyand's hernia, characterized by the presence of the vermiform appendix within the hernia sac in the dilated right inguinal canal. Amyand's hernia is a rare and clinically challenging condition to diagnose because its symptoms are nonspecific and often resemble those of other inguinal hernias. Delayed diagnosis can heighten the risk of complications, including inflammation, infection, perforation, and acute appendicitis. Mortality rates for Amyand's hernias have been reported to be between 14% and 30%, primarily due to complications associated with infections, especially peritoneal sepsis. Prompt diagnosis and treatment of Amyand's hernia, usually involving surgical hernia repair and an appendectomy if appendicitis is present, are highly effective in preventing potentially life-threatening complications. Despite their rarity, the difficult nature of the diagnosis and the associated high mortality rate underscore the importance of considering Amyand's hernia as a serious differential diagnosis.
