To recognise the imaging findings of an Amyand hernia and common pitfalls.

An Amyand hernia is a rare phenomenon occurring when the appendix is found within an inguinal hernia sac. It was first described in 1735 by Dr Claudius Amyand, King George II’s surgeon, when he found a perforated appendix inside an inguinal hernia sac in an 11-year-old boy during an appendicectomy.[1] Amyand hernias occur in less than 1% of inguinal hernias, most often in males and paediatric patients.[1,2] Most are right-sided but left-sided Amyand hernias have been reported in the literature in the context of intestinal...

An 81-year-old female presented to a major tertiary emergency department in Queensland with fevers, lower abdominal pain and nausea. On examination, the patient was febrile and had right iliac fossa tenderness and a palpable right inguinal lump. She had no clinical features of peritonitis. Relevant background included a distant history of bilateral inguinal hernia repairs. A CT of the abdomen and pelvis with portal venous phase IV contrast was performed. Typically, the appendix can be seen to have entered the inguinal sac on CT, confirming...

A unique case of an Amyand hernia associated with perforated appendicitis and an appendiceal neoplasm is described. This case highlights the importance of locating the appendix on imaging for patients with inguinal hernias as the presence of a complicated Amyand hernia may necessitate urgent surgical intervention. A common pitfall occurs when inflammatory changes obscure the appendix within the inguinal canal on CT. Comparison with prior imaging may be useful in these cases. Alternatively, further imaging such as an ultrasound or a CT with oral contrast,...

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