A Rare Case of Amyand's Hernia.

A hernia is an abnormal protrusion of an organ or tissue from its containing cavity. The most common type of abdominal hernia is an inguinal hernia. When a hernia is non-reducible, it is termed an incarcerated hernia. We present one such rare case of an incarcerated appendix within a right inguinal hernia, also called Amyand's hernia (AH). We discuss current approaches toward surgically repairing this type of complicated hernia and a complication that can arise if it is not repaired in a timely manner.

Pancreatic Dysfunction Masquerading as an Insulinoma.

Insulinoma is a rare neuroendocrine tumor that overproduces insulin, resulting in hypoglycemic symptoms. Elevated C-peptide levels in the absence of sulfonylurea use indicate insulinoma. Treatment is usually glucose administration and if the tumor size is large, surgery may be warranted. We present a case of a young man who had a one-year continuing episode of hypoglycemic symptoms that resolve after consuming high-glucose solids and liquids. Although symptoms pointed toward insulinoma, the 72-hour fasting test failed to show insulinoma. This case shows how following the algorithm accurately will prevent an inaccurate diagnosis.