Table 1: Classification of Amyand's hernias after Losanoff and Basson [3, 4].

ClassificationDescriptionSurgical management

Type 1Normal appendix within an inguinal herniaHernia reduction, mesh repair, appendectomy in young patients

Type 2Acute appendicitis within an inguinal hernia, no abdominal sepsisAppendectomy through hernia, primary endogenous repair of hernia, no mesh

Type 3Acute appendicitis within an inguinal hernia, abdominal wall or peritoneal sepsisLaparotomy, appendectomy, primary repair of hernia, no mesh

Type 4Acute appendicitis within an inguinal hernia, related or unrelated abdominal pathologyManage as types 1 to 3 hernia, investigate or treat second pathology as appropriate