Fishbone-Induced Appendicular Perforation: A Rare Case Report of Amyand’s Hernia

Abstract

Amyand's hernia is a rare type of hernia where the appendix is found to be the content of the inguinal hernial sac. It is most often diagnosed intraoperatively wherein the appendix may be found healthy, incarcerated, inflamed, or perforated. Claudius Amyand performed a successful appendectomy on a patient with an appendix noted in the inguinal canal and this condition was hence named after him. The incidence of Amyand's hernia is rare in inguinal hernia patients. There are no defined guidelines for the management of Amyand's hernia but adequate resuscitation followed by immediate appendectomy is widely followed.Here is a case report of a 60-year-old male presenting to the Emergency Department with an irreducible right-side inguinal hernia with features of small bowel obstruction. On exploration, Amyand's hernia was identified with appendicular tip perforation due to an impacted fishbone with pyoperitoneum. Appendectomy was done through midline laparotomy with impacted fishbone removal from the hernial sac with tissue repair of the hernia. There are as such no reported cases of fishbone-induced appendicular perforation in an Amyand's hernia in the available literature. After the exploration, we found the management of the case challenging regarding the closure of the hernia.

Automatic Recognition of Concealed Fish Bones under Laryngoscopy: A Practical AI Model Based on YOLO‐V5

“…1 In China, numerous patients visit clinics or emergency departments every day seeking medical assistance for stuck fish bones. Fish bones lodged in the digestive tract can lead to complications such as mucosal laceration, perforation, infection, bleeding, tracheoesophageal fistula, and, in rare cases, penetration into organs such as the stomach, 2 appendix, 3 liver, 4 pleura, 5 aortic arch, 6 and even the heart. 7 Prompt and efficient removal of fish bones is a fundamental skill for ENT physicians.…”