Amyand's hernia associated with acute appendicitis and incidental sessile serrated lesion in a recurrent incarcerated inguinal hernia: a case report.

Amyand's hernia, defined as the presence of the vermiform appendix within an inguinal hernia sac, is a rare clinical entity that is often diagnosed intraoperatively. We report the case of a 55-year-old man with a recurrent right inguinal hernia who presented with acute groin pain, nausea, vomiting, and signs of bowel obstruction. Preoperative imaging suggested an incarcerated inguinal hernia. Emergency surgical exploration revealed an inflamed appendix and cecal component within the hernia sac, confirming the diagnosis of Amyand's hernia. Appendectomy and modified Bassini repair were performed. Histopathological examination demonstrated acute appendicitis associated with a sessile serrated lesion and retention cyst without evidence of dysplasia or malignancy. Follow-up colonoscopy performed three months later showed no synchronous colorectal neoplasia. This case highlights the diagnostic challenges of Amyand's hernia and emphasizes the importance of routine histopathological examination and appropriate postoperative colorectal evaluation when unexpected appendiceal lesions are identified.