Abstract：
BACKGROUND: Amyand\'s hernia (AH)-where the appendix becomes incarcerated within the inguinal hernia (IH) sac-is rare, particularly if detected and operated concurrent with a contralateral recurrent IH.
METHODS: A 65-year-old man presented with symptomatic bilateral IH; the left IH was recurrent. Abdominopelvic computed tomography (CT) revealed a right IH with appendiceal herniation and left recurrent IH with omental fat. Using the prolene hernia system (PHS) mesh, the left recurrent IH underwent operation, followed by the right AH. The patient was in a good state with no recurrence 16 months postsurgery.
CONCLUSIONS: If AH is accidentally encountered during surgery, the procedure should differ depending on the inflammatory state of the appendix. Simultaneously operating AH and contralateral recurrent IH is complicated; it is necessary to preoperatively decide which side to operate on first and whether to use an anterior or laparoscopic posterior surgical approach. If the planned operation is unattainable, alternative surgery should be considered. Fortunately, herein CT was performed prior to surgery, and the surgical plan was properly established.
CONCLUSIONS: Prior to simultaneous AH and contralateral recurrent IH surgery, the surgical plan should be established. If the planned surgical technique for recurrent hernia repair is not feasible, an alternative should be performed. In AH repair, different surgical methods are required depending on the presence and severity of inflammation of the appendix.
METHODS: A 65-year-old man presented with symptomatic bilateral IH; the left IH was recurrent. Abdominopelvic computed tomography (CT) revealed a right IH with appendiceal herniation and left recurrent IH with omental fat. Using the prolene hernia system (PHS) mesh, the left recurrent IH underwent operation, followed by the right AH. The patient was in a good state with no recurrence 16 months postsurgery.
CONCLUSIONS: If AH is accidentally encountered during surgery, the procedure should differ depending on the inflammatory state of the appendix. Simultaneously operating AH and contralateral recurrent IH is complicated; it is necessary to preoperatively decide which side to operate on first and whether to use an anterior or laparoscopic posterior surgical approach. If the planned operation is unattainable, alternative surgery should be considered. Fortunately, herein CT was performed prior to surgery, and the surgical plan was properly established.
CONCLUSIONS: Prior to simultaneous AH and contralateral recurrent IH surgery, the surgical plan should be established. If the planned surgical technique for recurrent hernia repair is not feasible, an alternative should be performed. In AH repair, different surgical methods are required depending on the presence and severity of inflammation of the appendix.
摘要：
背景：Amyand\'s疝（AH）-阑尾在腹股沟疝（IH）囊内嵌顿-很少见，特别是如果检测到并与对侧复发性IH同时进行手术。
方法：一名65岁男性出现有症状的双侧IH；左侧IH复发。腹盆腔计算机断层扫描（CT）显示右侧IH伴阑尾疝，左侧IH伴网膜脂肪。使用普罗林疝系统(PHS)网片，左侧复发性IH行手术，其次是正确的AH。术后16个月，患者状态良好，无复发。
结论：如果在手术过程中意外遇到AH，程序应根据阑尾的炎症状态而有所不同。同时操作AH和对侧复发性IH很复杂；有必要在术前决定首先对哪一侧进行手术，以及是否使用前路或腹腔镜后路手术入路。如果计划的操作无法实现，应考虑替代手术。幸运的是,这里的CT是在手术前进行的，手术计划制定得当.
结论：在同时进行AH和对侧复发性IH手术之前，应制定手术计划。如果计划的复发性疝修补手术技术不可行，应该执行替代方案。在AH修复中，根据阑尾炎症的存在和严重程度，需要不同的手术方法。
方法：一名65岁男性出现有症状的双侧IH；左侧IH复发。腹盆腔计算机断层扫描（CT）显示右侧IH伴阑尾疝，左侧IH伴网膜脂肪。使用普罗林疝系统(PHS)网片，左侧复发性IH行手术，其次是正确的AH。术后16个月，患者状态良好，无复发。
结论：如果在手术过程中意外遇到AH，程序应根据阑尾的炎症状态而有所不同。同时操作AH和对侧复发性IH很复杂；有必要在术前决定首先对哪一侧进行手术，以及是否使用前路或腹腔镜后路手术入路。如果计划的操作无法实现，应考虑替代手术。幸运的是,这里的CT是在手术前进行的，手术计划制定得当.
结论：在同时进行AH和对侧复发性IH手术之前，应制定手术计划。如果计划的复发性疝修补手术技术不可行，应该执行替代方案。在AH修复中，根据阑尾炎症的存在和严重程度，需要不同的手术方法。
