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Granuloma Annulare
Joseph Junewick, MD FACR
over 7 years ago
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Amyand's Hernia

Case Detail

Anatomy: Gastrointestinal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Infectious-Inflammatory
Created: over 6 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: US
Activities:
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History

3 week old premature male with inguinal mass and abdominal distention; rule out incarcerated hernia.


Case Images


Diagnosis

Acute Appendicitis in Inguinal Canal

Clinical Notes

Pathology – Acute appendicitis with ischemic changes.

Findings

US – The appendix penetrates the internal ring of the inguinal canal and is associated with adjacent fluid collection. Note that the appendix is hyperemic on color Doppler and may have intramural air.

Discussion

Claudius Amyand performed the first appendicectomy on a perforated appendix within the inguinal hernia sac of an 11-year-old boy in 1735. His name has now become eponymous with this rare condition. A normal appendix in an inguinal hernial sac is thought to occur three times more often in infants than adults due to persistent patency of the processus vaginalis. The predisposition has also been associated with a congenital band extending from the appendix into the scrotum and attached to the right testis and the funnel-shaped tapering caecum of the neonate which allows the appendix to enter the inguinal canal.

Reference

Milburn JA and Youngson GG. Amyand’s hernia presenting as neonatal testicular ischaemia. Pediatric Surgery International (2006); 22(4):390-392.

Contributor

Linda Woolpert, RDMS



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