SQU Med J, May 2012, Vol. 12, Iss. 2, pp. 232-236, Epub. 9 th Apr 2012 Submitted 10 th Oct 11 Revision Req. 31 st Dec 11, Revision recd. 20 th Jan 12 Accepted 15 th Feb 12 T he contents of inguinal hernia sacs difer from case to case. Various structures contained therein have been described, but the presence of the appendix in an inguinal hernia sac is rare. Tis anomaly was frst described by Claudius Amyand in an 11-year-old boy who underwent a successful appendectomy in 1735. 1 Te incidence of appendicitis within an inguinal hernia is estimated at 0.07–0.13 %. 2 Te eponym Amyand’s hernia was frst coined by Creese in 1953, then by Hiatt and Hiatt in 1988, followed by Hutchinson in 1993. 3–6 We report four cases of Amyand's hernia operated upon in the Department of Surgery at Sultan Qaboos University Hospital, Oman, in the period 2007 to 2011. Patient follow-up ranged from one month to three years with no surgical site infection seen in the immediate post-operative period, or recurrence of the hernia. Te purpose of this report is to create general awareness among surgeons who might be dealing with this hernia surgery, as they may encounter unexpected intraoperative fndings such as Amyand’s hernia. It is important to be aware of all clinical possibilities and appropriate management techniques. Case One A 64-year-old male, who had had a left-sided reducible inguinal hernia for the previous 5 years, presented with a 2-day-history of fever, pain, vomiting, and irreducibility of the hernia. He had noticed a recent increase in the swelling size. On examination, he was found to be dehydrated with a temperature of 38° C and a heart rate of 104 beats per minute (bpm). He had bilateral pedal oedema and bibasilar crepitations in his chest. His abdomen was distended with exaggerated bowel sounds. Tere was a 30 x 15 cm pear-shaped left inguino-scrotal Department of Surgery, Sultan Qaboos University Hospital, Muscat, Oman *Corresponding Author e-mail: ali_2051@hotmail.com, and alismc2051@gmail.com مياند فتق ا اجعة النشورات بع حالت مع مر عن أر تقرير لقا�سين ان مالك، ها د علي، كمرا ّ �سي كت�سف غالباي ل تدرة التلنالت الاد من اميان. يعتب فتق افتق الآربية بكي�س الوديرة عن احتواء الزائدة الدمياند هو عبا فتق الخ�ص: ال ل�ساعفاتة ملتهبة مع ا تكون بحال الطبيعية اأولفتق بحالتهاة بكي�س اودي آربي. قد تكون الزائدة الدفتق اللراحي ل التدخلء الأثنا اإل ا لجراحةت لالذه ال، خ�سعت هلطان قابو�سمعه ال�سست�سفى جامياند ب� من فتق ا و�سفا لأربع حالتج ف هذا التقريرحتملة. ندر ال ح الفتق بغرزة برولي.د قمنا باإ�سللة الرابعة فقلا اأمالت، الث حا�سبكة طبية ف ث الفتق بودية مع اإ�سلح الزائدة الدستئ�سال با� مان. ُ اد، تقرير حالة، عودية الب الزائدة الدلتها دودية داخل فتق،افتق الآربي، زائدة الكلمات:ح ال مفتا : Te presence of the appendix in an inguinal hernial sac is described as Amyand’s hernia. It is a rare entity which presents mostly at the exploration of the inguinal canal. Te appendix may be apparently normal or have all the features of acute appendicitis with its possible complications. We report four cases of Amyand’s hernia which were treated at Sultan Qaboos University Hospital, Oman. All patients underwent appendectomy. In three cases, the inguinal hernia were repaired with Vipro mesh while, in the remaining case, a darning repair was done with Prolene sutures. Keywords: Inguinal hernia; Appendix in hernia; Acute appendicitis; Case report; Oman. Amyand’s Hernia Study of four cases and literature review *Syed M. Ali, Kamran A. Malik, Hani Al-Qadhi CASE REPORT