Amyand’s hernia is an extremely rare condition in which the appendix is positioned in the inguinal hernia sac. Acute appendicitis is much less common in this situation and few reports are found in the literature. We report a case of acute appendicitis with the tip of the appendix incarcerated outside the external ring of the right groin. A mobilized cecum and ascending colon were noticed during surgery. We conducted a review of the literature, emphasizing possible causes and suggesting a predisposing factor for the condition.

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