Amyand’s hernia in adult and pediatric practice. Urological aspects

Abstract

Amyands hernia, an inguinal hernia that contains the appendix within the hernia sac, is a rare condition in surgical, and even more so in urological practice. It is difficult to diagnose due to its low frequency, anatomical atypicality and urgency. There are no review publications on this issue, and those that are available are mainly descriptions of individual cases. In this article an attempt was made to highlight the largest possible number of clinical observations that reflect the urological aspects of the problem and present them in a systematic manner. Aim to analyze the available publications covering the urological aspects of Amyands hernia.
 The literature review was carried out on the basis of publications covering the urological aspects of Amyands hernia in adults and children, published in PubMed databases and Scientific Electronic Library eLibrary.ru. The search was carried out by the following keywords: Amyands hernia, acute scrotum, inflammatory diseases of the scrotum, Fourniers phlegmon, scrotal fistula (in Russian and English). Taking into account the rarity of the analyzed problem, the analysis includes publications for the last 15 years. 189 publications related to the topic of the review were identified. 38 publications of the greatest scientific and practical interest were selected directly for citation in the review. The maximum number of available publications reflecting the urological aspects of Amyands hernia has been analyzed, and an attempt has been made to systematize them clinically. The variety of clinical manifestations caused by Amyands hernia is commonly referred to in the English literature as Amyands hernia syndrome. We have identified the following variants of the clinical course: scrotal fistula a casuistic variant described in detail only by C. Amyand; picture of the acute scrotum syndrome the most frequent variant of the clinical course of Amyands hernia with scrotal manifestations is noted mainly in childhood, however, it can also occur in adults in all age groups; phlegmon of the scrotum, phlegmon of Fournier an extremely rare variant of the clinical course with scrotal manifestations, publications on this subject are rare.
 Amyands hernia being a rare surgical problem in both children and adults, has a number of urological masks, causing diagnostic difficulties and is of some interest to the urologists.