Amyand's hernia is a rare event estimated at 0.1% of all acute appendicitis.1
It occurs in all ages. But its discovery in the neonatal period as in our case is exceptional.2 3
Pathogenesis is not well understood. The role of microtraumatism and compression of the appendix in the sac disturbing its blood supply has been invoked. Amyand's hernia is rarely diagnosed preoperatively. Few cases have been discovered before surgery.4
Signs are not specific and may mimic strangulated inguinal hernia, testicular torsion, epididymo-orchitis and inguinal lymphadenitis. In these difficult cases, ultrasound or CT may be useful.4
In any case, surgical exploration through inguinal incision must be performed quickly to avoid complications. The postoperative course is usually favourable. Few deaths were reported in the literature.5
For our neonate, preoperative diagnosis was that of a strangulated inguinal hernia because of the frequency of this complication in this age and the irreducibility of the mass on clinical examination.
- The field: neonate
- The most important differential diagnosis: strangulated inguinal hernia.