Amyand's hernia in a 2-month-old infant: The first case report from Sudan.

INTRODUCTION AND IMPORTANCE: Amyand's hernia (AH) is an extremely rare type of inguinal hernia where the vermiform appendix is present within the inguinal hernia sac. This report documents the first known instance of AH in Sudan, highlighting its unprecedented occurrence in this region. CASE PRESENTATION: A 2-month-old infant presented to the ER with an obstructed right-sided inguinal hernia for 6 h. During surgical repair, an inflamed appendix was found within the hernial sac. The appendix was ligated, excised, herniotomy was performed to repair the hernia, and the appendix was sent for histopathological examination. CLINICAL DISCUSSION: This case underscores the importance of recognizing rare presentations of common conditions in different geographical and demographic contexts. The co-occurrence of acute appendicitis and AH in infants poses a diagnostic challenge, often only detected incidentally during surgical exploration. CONCLUSION: By presenting this unique case, we aim to raise awareness about the potential for such rare hernias in pediatric populations. Early recognition and proper management are crucial for ensuring optimal patient outcomes and preventing complications associated with delayed diagnosis or treatment.

Hidden for years: Torsion and infarction in the wandering spleen of a 45-year-old woman.

INTRODUCTION AND IMPORTANCE: Wandering spleen (WS), characterized by abnormal mobility due to laxity of its ligaments, is a rare condition often presenting diagnostic challenges. Its complications, such as torsion and infarction, necessitate prompt recognition and management to prevent life-threatening outcomes. CASE PRESENTATION: We report a case of a 45-year-old female presenting with acute abdominal pain, constipation, and a palpable mass in the right iliac fossa. Imaging revealed a torsion of a wandering spleen, a rare occurrence exacerbated by delayed diagnosis despite a decade of symptoms. CLINICAL DISCUSSION: Diagnostic imaging, including abdominal ultrasound and CT scan, played a crucial role in confirming the ectopic spleen and guiding surgical intervention. Immediate laparotomy revealed a twisted spleen necessitating splenectomy due to non-viability post-detorsion attempt. CONCLUSION: This case underscores the importance of considering wandering spleen in the differential diagnosis of acute abdominal pain, especially in patients with chronic intermittent symptoms. Surgical intervention remains the definitive treatment, emphasizing the risks associated with conservative management in preventing complications.