Eponymous Hernia
A hernia is the protrusion of a viscus or tissue through the wall of the cavity that normally contains it. Clinically we separate external (e.g., inguinal, femoral, umbilical, ventral/incisional, Spigelian) from internal/diaphragmatic (e.g., hiatal, para-oesophageal, Bochdalek, Morgagni), then describe site, sac contents, and status (reducible, incarcerated, strangulated).
Eponymous hernias capture what’s inside the sac (e.g., Amyand (appendix: inguinal hernia); de Garengeot (appendix: femoral hernia); Littre (Meckel’s diverticulum)) or where the defect lies (e.g., Spigelian, Bochdalek, Morgagni). The eponym is a convenient label; the safe description is anatomical: state the location, contents, and complications, then add the eponym if it adds clarity.
Etymology: hernia from Latin hernia (“rupture”); inguinal from Latin inguen (“groin”); femoral from Latin femur (“thigh”).
Amyand’s hernia (1735)
Amyand’s hernia describes the presence of the vermiform appendix within an inguinal hernia sac, whether inflamed or not. Case reports range from incidental finding to incarcerated hernia with appendicitis or perforation. Management depends on appendix status (normal vs inflamed) and degree of contamination; mesh is avoided in infected fields.
Reported prevalence of Amyand’s hernia is 0.4–0.6% of all inguinal hernias, with appendicitis within an Amyand hernia in ~0.07–0.13%. In children, prevalence may reach ~1%. There is a male predominance (≈90% in reviews) and often right-sided due to anatomical predisposition.
At operation, Amyand found a perforated appendix (penetrated by a swallowed pin); within the inguinal canal which he excised, making this the first documented appendicectomy.
- Claudius Amyand (c.1680-1740) was a French-born English surgeon
- Amyand C. Of an inguinal rupture, with a pin in the appendix caeci, incrusted with stone; and some observations on wounds in the guts. Phil. Trans. R. Soc., 1736, 39: 329-336
De Garengeot’s Hernia (1731)
De Garengeot’s hernia refers to a femoral hernia containing the vermiform appendix
1731 – Garengeot described a 55-year-old woman who developed a painful right groin swelling after lifting bread. At operation, a femoral hernia was found containing the appendix, which was reduced and the patient recovered.
Original
English
…Je trouvai dans le sac herniaire un petit corps allongé, adhérent, que je reconnus pour l’appendice du caecum. Je le remis dans le ventre, et après avoir pratiqué la cure ordinaire de la hernie, la malade se rétablit – de Garengeot, 1731
…I found in the hernial sac a small elongated body, adherent, which I recognised as the appendix of the caecum. I returned it into the abdomen, and after carrying out the usual cure of the hernia, the patient recovered – de Garengeot, 1731
- René-Jacques Croissant de Garengeot (1688-1759) was a French surgeon
- De Garengeot RJC. Traité des opérations de chirurgie, fondé sur la mécanique des organes de l’homme, et sur la théorie et la pratique la plus autorisée. 1731, 2e [Hernia: 369–371]
Littré’s Hernia (1700)
Littré’s hernia refers to the protrusion of a Meckel’s diverticulum into a hernial sac. Though very rare, it carries clinical importance because of its risk of strangulation, necrosis, and perforation. The condition has been reported in less than 0.1% of all strangulated or incarcerated hernias. Reported sites include inguinal (~50%), femoral (~20%), umbilical (~20%), and rare parastomal cases.
Patients typically present with a painful hernial swelling, and diagnosis is often made intraoperatively. Surgical management consists of excision of the diverticulum and definitive hernia repair, with mesh repair avoided in contaminated fields.
1700 – Littré described his Observations sur une nouvelle espèce de hernie, which were published in the Histoire de l’Académie Royale des Sciences in 1719. He reported post-mortem cases where a small portion of ileum formed a diverticulum and extended into the hernia sac.
Original
English
Une nouvelle espèce de hernie… formée par une petite portion de l’intestin grêle, prolongée en dehors du tube, comme une espèce de vessie, et tombant dans la poche herniaire – Littré, 1700
A new kind of hernia… formed by a small portion of the small intestine, prolonged outward from the tube like a kind of bladder, and falling into the hernial sac. – Littré, 1700
1809 – Johann Friedrich Meckel (the younger) (1781-1833) established the congenital nature of the outpouchings (Meckel’s diverticulum), recognising them as embryological remnants of the vitelline duct.
- Alexis Littré (1654-1726) was a French anatomist and surgeon
- Littre A. Observations sur une nouvelle espèce de hernie. Histoire de l’Académie royale des sciences avec les Mémoires de mathematique et de physique. 1700: 300-310
eponymythology
the myths behind the names
