Abstract
INTRODUCTION: Inguinal hernias containing the appendix are described as Amyand's hernias. The surgical approach to these types of hernias is dependent on the type present and associated intra-operative findings. PRESENTATION OF CASE: We present a case of complicated type IV Amyand's hernia, which was managed though combined abdominal and inguinal approach. Though the patient had a prolonged post-operative course due to pulmonary embolism, he progressed to full recovery. DISCUSSION: The different grades of Amyand's hernia are repaired in varying ways, including laparoscopic and open approaches with or without mesh. The type of repair must be tailored to the patient and disease process. CONCLUSION: Primary repair of a perforated Amyand's hernia provides adequate strength with decreased risk of infection due to synthetic material.