scholarly journals Emergency surgery in an elective setting: a case report detailing incidental diagnosis of a de Garengeot hernia

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Conor Brosnan ◽  
Shane Keogh ◽  
Jarlath C Bolger ◽  
Kevin Farrell ◽  
Enda Hannan ◽  
...  
Keyword(s):  
Femoral Hernia ◽  
Elective Surgery ◽  
Rare Complication ◽  
Vermiform Appendix ◽  
Hernia Sac ◽  
First Case ◽  
Satisfactory Outcome ◽  
Elective Setting ◽  
Decisive Action ◽  
De Garengeot Hernia

Abstract We present a case of acute appendicitis within an incarcerated femoral hernia. This is a rare complication of the phenomenon eponymously known as a ‘De Garengeot Hernia’, which describes a vermiform appendix in an incarcerated femoral hernia sac. Our case is somewhat unique in the manner by which the affected patient had presented. Attending hospital for an unrelated elective surgery, an incarcerated hernia was diagnosed at time of admission. Thorough assessment in advance of the procedure and decisive action led to a satisfactory outcome. This may be the first case in literature reporting a ‘De Garengeot Hernia’ presenting in such a fashion.

scholarly journals Unusual case of De Garengeot hernia: femoral hernia containing purulent appendicitis in a 69-year-old man

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110284
Author(s):  
Longchao Yan ◽  
Yingyi Zhang
Keyword(s):  
Femoral Hernia ◽  
Surgical Procedure ◽  
Preoperative Diagnosis ◽  
Unusual Case ◽  
Single Incision ◽  
Vermiform Appendix ◽  
Rare Type ◽  
Common Procedure ◽  
Hernia Sac ◽  
De Garengeot Hernia

A De Garengeot hernia is a rare type of femoral hernia that involves a vermiform appendix within a femoral hernia sac. Because of the rarity of this disease, a standard surgical procedure has not been established, and most cases are diagnosed intraoperatively. Preoperative diagnosis of a De Garengeot hernia is quite difficult. Computed tomography is the most sensitive and specific technique among the available imaging tests for preoperative diagnosis of a De Garengeot hernia. Although a standard surgical procedure is lacking, prompt surgery has become the consensus. The most common procedure is the open anterior approach; this allows exploration of the hernia sac and rapid treatment of its contents, routine appendectomy through a single incision, and preperitoneal repair of the femoral hernia.

scholarly journals The rare case of De Garengeot hernia: femoral hernia containing perforated appendicitis

2019 ◽  
Vol 2019 (11) ◽  
Author(s):  
Lei Ying ◽  
Jeong-Moh John Yahng
Keyword(s):  
Femoral Hernia ◽  
Rare Case ◽  
Clinical Symptoms ◽  
Perforated Appendicitis ◽  
Vermiform Appendix ◽  
Hernia Sac ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Groin Hernias ◽  
De Garengeot Hernia

Abstract Femoral hernias account for ~4% of all groin hernias but are much more common in females, especially those over the age of 70. Risk of incarceration is overall low but can include structures such as bowel, omentum, bladder, ovary and very rarely, the appendix. The subset of femoral hernias containing the vermiform appendix is known as de Garengeot hernias. We describe a rare case of an 87-year-old female patient who presented with an incarcerated right femoral hernia confirmed on contrast-enhanced computed tomography scan of the abdomen and pelvis, with subsequent open hernia reduction revealing a perforated necrotic appendix with pus contained in the hernia sac. Histopathology revealed acute appendicitis with increased stromal fibrosis suggestive of a chronic process. Pre-operative diagnosis of de Garengeot hernias remains challenging due to their non-specific presentation and attenuated clinical symptoms, and most diagnoses are made intraoperatively.

scholarly journals Unusual presentation of De Garengeot hernia

2019 ◽  
Vol 12 (7) ◽  
pp. e230455 ◽  
Author(s):  
Chang Woo Lee ◽  
Angelos Mantelakis ◽  
Md Abu K Nahid ◽  
Ashish Shrestha
Keyword(s):  
Weight Loss ◽  
Ct Scan ◽  
Femoral Hernia ◽  
Vermiform Appendix ◽  
Lymph Node Biopsy ◽  
Hernia Sac ◽  
History Of ◽  
Systemic Symptoms ◽  
Loss Of Appetite ◽  
De Garengeot Hernia

De Garengeot hernia describes a rare phenomenon in which a vermiform appendix is found in a femoral hernia sac. We describe a case of De Garengeot hernia presenting as a groin lump associated with loss of appetite, weight loss and fatigue. A 72-year-old woman was referred to our rapid access 2-week clinic as isolated lymphadenopathy with a 4-week history of a gradual right groin swelling accompanied by an unintentional weight loss, lethargy and anorexia. An urgent excisional lymph node biopsy was performed preceding the CT scan of the chest, abdomen and pelvis. The biopsy showed a shaving of appendix wall, and the CT scan revealed a right-sided femoral hernia with appendix as its content. The patient was urgently contacted for a laparoscopic appendicectomy and an open right femoral hernia repair. The patient recovered well postoperatively, and her systemic symptoms fully resolved when reviewed 10 weeks after the operation.

scholarly journals Rare presentation of De Garengeot hernia in a 77-year-old woman

2020 ◽  
Vol 13 (4) ◽  
pp. e232419
Author(s):  
Marjan Raad ◽  
Tord Høgsand ◽  
Muhammed Saeed Qureshi ◽  
James Pitt
Keyword(s):  
Hernia Repair ◽  
Femoral Hernia ◽  
Groin Pain ◽  
Open Appendectomy ◽  
Vermiform Appendix ◽  
Nausea And Vomiting ◽  
Rare Presentation ◽  
Hernia Sac ◽  
De Garengeot Hernia

A 77-year-old woman presented with a rare surgical phenomenon known as De Garengeot hernia. This unique presentation occurs due to the presence of a vermiform appendix in a femoral hernia sac. The patient presented with right-sided groin pain and a partially reducible hernia; she was otherwise haemodynamically stable and denied fevers, nausea and vomiting. The diagnosis was confirmed with CT which demonstrated a right-sided femoral hernia containing a perforated tip of the appendix. The patient urgently underwent an open appendectomy and open right femoral hernia repair using the modified McEvedy’s incision.

scholarly journals De Garengeot’s hernia with appendicitis—a rare cause of an acutely painful groin swelling

2019 ◽  
Vol 2019 (5) ◽  
Author(s):  
Adam O’Connor ◽  
Peter Asaad
Keyword(s):  
Acute Appendicitis ◽  
Hernia Repair ◽  
Mesh Repair ◽  
Vermiform Appendix ◽  
Short Review ◽  
Review Of The Literature ◽  
Hernia Sac ◽  
De Garengeot’S Hernia ◽  
De Garengeot Hernia ◽  
Groin Swelling

Abstract De Garengeot hernia is a rare subtype of femoral hernia whereby the vermiform appendix is located within the hernial sac. Even rarer is the presence of appendicitis within the hernia sac. De Garengeot’s hernia is difficult to diagnose pre-operatively and can prove technically difficult at operation particularly with regards to mobilization of the caecum and appendix in order to perform appendicectomy. Laparoscopic, open, with and without mesh repair of de Garengeot hernia have all been described in the literature with varying degrees of success. We present a case of an 82 year old lady presenting with an acutely painful right sided groin lump. CT scan revealed the presence of de Garengeot hernia with acute appendicitis. We describe in text and photo format our approach to the hernia repair, appendicectomy and provide a short review of the literature with regards to the different operative approaches to such a patient.

De Garengeot Hernia: Appendicitis within a Femoral Hernia

2005 ◽  
Vol 71 (6) ◽  
pp. 526-527 ◽  
Author(s):  
Gabriel Akopian ◽  
Magdi Alexander
Keyword(s):  
Inguinal Hernia ◽  
Femoral Hernia ◽  
18Th Century ◽  
Hernia Sac ◽  
Rare Finding ◽  
Amyand Hernia ◽  
De Garengeot Hernia

Many surgeons are familiar with Amyand hernia, which is an inguinal hernia sac containing an appendix. However, few surgeons know of the contribution of Rene Jacques Croissant de Garengeot, an 18th century Parisian surgeon, to hernias. He is quoted in the literature as the first to describe the appendix in a femoral hernia sac. We discuss the case of an 81-year-old woman who presented with appendicitis within a femoral hernia, a rare finding at surgery that is almost never diagnosed preoperatively. We also propose crediting Croissant de Garengeot by naming this condition after him. Although his full last name is Croissant de Garengeot, for convenience we suggest the simple diagnosis of “de Garengeot hernia.”

scholarly journals Type 4 appendiceal diverticulum within a de Garengeot hernia

2016 ◽  
Vol 98 (7) ◽  
pp. e141-e142 ◽  
Author(s):  
SH Rossi ◽  
E Coveney
Keyword(s):  
Femoral Hernia ◽  
Cystic Lesion ◽  
Vermiform Appendix ◽  
Clinical Suspicion ◽  
Intraluminal Pressure ◽  
Rare Entity ◽  
History Of ◽  
The Right ◽  
De Garengeot Hernia ◽  
Learning Points

A de Garengeot hernia is defined as an incarcerated femoral hernia containing the vermiform appendix. We describe the case of a patient with a type 4 appendiceal diverticulum within a de Garengeot hernia and delineate valuable learning points.A 76-year-old woman presented with a 2-week history of a non-reducible painless femoral mass. Outpatient ultrasonography demonstrated a 36mm × 20mm smooth walled, multiloculated, partially cystic lesion anterior to the right inguinal ligament in keeping with an incarcerated femoral hernia. Intraoperatively, the appendix was found to be incarcerated in the sac of the femoral hernia and appendicectomy was performed. Histopathology demonstrated no evidence of inflammation in the appendix. However, an incidental appendiceal diverticulum was identified.It is widely recognised that a de Garengeot hernia may present with concomitant appendicitis, secondary to raised intraluminal pressure in the incarcerated appendix. Appendiceal diverticulosis is also believed to develop in response to raised pressure in the appendix and may therefore develop secondary to incarceration in a de Garengeot hernia. To our knowledge, only one such case has been described in the literature. A de Garengeot hernia is a rare entity, which poses significant diagnostic challenges. A high index of clinical suspicion is necessary as these hernias are at particularly high risk of perforation and so prompt surgical management is paramount.

De Garengeot hernia: a rare case in an elderly woman and a review of operative approaches

2021 ◽  
Vol 14 (4) ◽  
pp. e240557
Author(s):  
Syaza Zainudin ◽  
Firdaus Hayati ◽  
Tharanrajh Arumugam ◽  
Kah Yee Ho
Keyword(s):  
Mesh Repair ◽  
Rare Case ◽  
Case Reports ◽  
Vermiform Appendix ◽  
Suture Technique ◽  
Surgical Approaches ◽  
Hybrid Surgery ◽  
Hernia Sac ◽  
Acute Setting ◽  
De Garengeot Hernia

De Garengeot hernia is a rare finding of the vermiform appendix inside a femoral hernia sac. We report this occurrence in a 73-year-old woman who presented in the acute setting. There are no standardised surgical approaches and many different techniques have been described in case reports in the literature. We conducted a literature review of and found a total of 113 cases with addition of our case 114 unique cases were included for analysis. Inguinal incision was most cited (n=89). Concomitant laparotomy was needed in 13 patients, however, the association between type of incision and additional laparotomy was not significant (p>0.05). Laparoscopic surgery alone was performed in eight patients. Nine patients had hybrid surgery. The most common hernia repair was through suture technique with non-absorbable material (n=31). Mesh repair was used in 28 cases. More laparoscopic surgeries were done when the disease was diagnosed preoperatively (7/39, p<0.05).

scholarly journals A Rare Case of Chronic Appendicitis Superimposed on an Incarcerated de Garengeot Hernia Prospectively Identified on Computed Tomography

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Alyssa Goldbach ◽  
Partha Hota ◽  
Andrew Czulewicz ◽  
Christine Burgert-Lon ◽  
Omar Agosto
Keyword(s):  
Femoral Hernia ◽  
Surgical Intervention ◽  
Incidental Finding ◽  
Critical Role ◽  
Fluid Collection ◽  
Cross Sectional ◽  
Chronic Appendicitis ◽  
Hernia Sac ◽  
Cross Sectional Imaging ◽  
De Garengeot Hernia

The de Garengeot hernia is an uncommon and potentially confounding pathologic process in which the appendix is contained within a femoral hernia. While typically a benign incidental finding, superimposed acute appendicitis is a rare but serious complication. Identification of this entity is crucial to patient management and ultimately outcome with imaging playing a critical role. Cross-sectional imaging, with either CT or MRI, should be performed in all cases of suspected incarcerated de Garengeot hernia to facilitate the appropriate diagnosis and surgical intervention. Herein, we present the fifth case of a prospective CT diagnosis of the de Garengeot hernia in a 61-year-old female who presented with an irreducible right femoral hernia. The patient underwent CT examination which demonstrated the appendix within the femoral hernia sac with an associated periappendiceal fluid collection. The patient was taken for emergent surgical intervention at which time the appendix was found within the hernia sac. The appendix was removed, the defect repaired, and ultimately the patient recovered well.

scholarly journals Case report: Amyand hernia reincarnate and the utility of computed tomography

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Joshua Fields ◽  
Kristen Quinn ◽  
Laura Hollinger ◽  
Richard Jones
Keyword(s):  
Foreign Body ◽  
Hernia Repair ◽  
Rare Condition ◽  
Vermiform Appendix ◽  
Lower Quadrant ◽  
Hernia Sac ◽  
Case Presentation ◽  
First Case ◽  
Original Case ◽  
Amyand Hernia

Abstract Background An Amyand hernia is a rare condition in which the vermiform appendix follows the bowel as it bulges through the inguinal canal. Originally described by Claudius Amyand in 1735 in an 11-year-old boy who had a pin in the appendix (Philos Trans R Soc Lond. 1735;39:329–36), we describe here the first case with CT depicting all components of Dr. Amyand’s original case. Case presentation A 10-year-old boy presented with right lower quadrant and groin pain. CT imaging revealed a retained metallic foreign body perforating the appendix, acute appendicitis, and an Amyand hernia. A laparoscopic attempt at reduction failed due to tethering by the needle and inflammation of the hernia sac, requiring an open inguinal exploration and excision of the hernia sac. The patient was discharged on postoperative day 2 with plans for delayed hernia repair. Conclusions CT is a crucial diagnostic test for surgical decision-making in Amyand hernias. In this case, it accurately classified the hernia and led to anticipation of unsuccessful laparoscopic hernia reduction. Management in the setting of foreign body and perforation includes appendectomy and tissue herniorrhaphy with delayed formal inguinal hernia repair after inflammation has subsided.

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