143 Med Arh. 2013 Apr; 67(2): 143-144 • CASE REPORT Amyand’s Hernia in Forensic Autopsy: Case Report and Review of the Literature DOI: 10.5455/medarh.2013.67.143-144 Med Arh. 2013 Apr; 67(2): 143-144 Received: November 28th 2012 | Accepted: December 25th 2012 CONFLICT OF INTEREST: NONE DECLARED CASE REPORT Amyand’s Hernia in Forensic Autopsy: Case Report and Review of the Literature Nursel Türkmen 1 , Bülent Eren 2 , Halis Dokgöz 3 Uludağ University Medical Faculty, Forensic Medicine Department, Council of Forensic Medicine of Turkey, Bursa Morgue Department, Bursa, Turkey 1 Council of Forensic Medicine of Turkey, Bursa Morgue Department, Bursa, Turkey 2 Mersin University Medical Faculty, Forensic Medicine Department, Mersin, Turkey 3 T he presence of vermiform appendix in inguinal hernia is rare and is known as Amyand’s hernia. Reported case was 73 years old man admitted to the hospital with chest pain who dead soon after admittance in the emergency department of the university hospital. In the macroscopic autopsy investigation, after opening the hernial sac, the vermiform appendix and caecum were detected free, without adhesions in the hernial sac. Death was reported due to acute myocardial infarction. Investigation of this rare entity in forensic autopsy is important for scientifc classifcation, description and also correct pre-postoperative management and appropriate surgery. Key words: Amyand’s Hernia, Forensic Autopsy. Corresponding author: Bülent Eren, MD. Council of Forensic Medicine of Turkey, Bursa Morgue Department, Heykel, Osmangazi 16010, Bursa, Turkey. Tel: +90 224 222 03 47. Fax:+090 224 225 51 70. E-mail:drbulenteren@gmail.com. 1. INTRODUCTION Acute appendicitis in an ingui- nal hernia sac was referred as Amy- and’s hernia to honour Claudius Amy- and, who was the frst who described the presence of a perforated appen- dix within the inguinal hernial sac in 1735(1–7). Investigation of anatomic and pathological features of this rare entity in forensic autopsy is important determinants for scienti fc classifca- tion, description also correct pre-post- operative managements and appropri- ate surgery. 2. CASE REPORT Reported case of Amyand’s hernia is male aged 73 years, where the appen- dix was found in a right inguinal her- nia during forensic autopsy. Te medi- cal history of the patient included arte- rial hypertension history with medical treatment. Te victim was admitted to the hospital with chest pain who dead soon after admittance in the emergency department of the university hospital. Te death was considered to be suspi- cious by prosecutor and an autopsy was mandated. Gross external examination detected swelling in the right inguinal region (Figure 1). In the macroscopic autopsy investigation, the deep facia, the external oblique apo- neurosis and the sper- matic cord were iden- tifed after opening the hernial sac; the vermi- form appendix and cae- cum were detected free, without adhesions in the hernial sac (Figure 2). In the macroscopic investi- gation; the appendix was 11 cm in length with a maximum diameter of 0.7 cm. Histological in- vestigation did not reveal any patho- logical fndings of the appendix ver- miformis. Analysis of the organ speci- mens revealed none of the substances screened for in systematic toxicological methods. Macroscopic examination of brain, both lungs showed edema and congestion. Histological examination of the heart revealed fndings corre- sponding acute myocardial infarction. Death was reported due to acute myo- cardial infarction. 3. DISCUSSION Amyand’s hernia is a rare hernia in which an incarcerated or perforated ap- pendix is found in the right inguinal ca- nal (1-7). Te presence of having a nor- mal appendix within the hernial sac is a rare disease, reported in 1% of cases of inguinal hernia repair. Te appendix can be complicated by acute appendici- Figure 1 External apperance