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.

scholarly journals Mesh Inguinal Hernia Repair and Appendectomy in the Treatment of Amyand’s Hernia with Non-Inflamed Appendices

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Emin Kose ◽  
Abdullah Sisik ◽  
Mustafa Hasbahceci
Keyword(s):  
Inguinal Hernia ◽  
Acute Appendicitis ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Vermiform Appendix ◽  
Amyand’S Hernia ◽  
Hernia Sac ◽  
Male Patients ◽  
Variable Clinical Presentation

Amyand’s hernia is defined as protrusion of the vermiform appendix in an inguinal hernia sac. It is a rare entity with variable clinical presentation from normal vermiform appendix to abscess formation due to perforation of acute appendicitis. Although surgical treatment includes appendectomy and hernia repair, appendectomy in the absence of an inflamed appendix and use of a mesh in cases of appendectomy remain to be controversial. The aim of this study was to review the experience of mesh inguinal hernia repair plus appendectomy performed for Amyand’s hernia with noninflamed appendices. There were five male patients with a mean age of 42.4 ± 16.1 years in this retrospective study in which Amyand’s hernia was treated with mesh inguinal hernia repair plus appendectomy for noninflamed appendices. Patients with acute appendicitis and perforated vermiform appendix were excluded. There were four right sided and one bilateral inguinal hernia. Postoperative courses were uneventful. During the follow-up period (14.0 ± 7.7 months), there was no inguinal hernia recurrence. Mesh inguinal hernia repair with appendectomy can be performed for Amyand’s hernia in the absence of acute appendicitis. However, presence of fibrous connections between the vermiform appendix and the surrounding hernia sac may be regarded as a parameter to perform appendectomy.

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 De Garengeot Hernia: A Challenging Diagnosis and a New Approach

2021 ◽  
pp. 1-3
Author(s):  
Sleiman Marwan Julien ◽  
Sleiman Marwan Julien ◽  
Litchinko Alexis ◽  
Toso Christian ◽  
Ris Frédéric ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Hernia Repair ◽  
Femoral Hernia ◽  
Clinical Presentation ◽  
Emergency Setting ◽  
Rare Presentation ◽  
Hernia Sac ◽  
Double Approach ◽  
The Right ◽  
De Garengeot Hernia

De Garengeot’s hernia is a rare entity in which the appendix is located within a femoral hernia and is almost invariably encountered incarcerated in an emergency setting. The clinical presentation is usually that of an incarcerated femoral hernia and is indistinguishable from other incarcerated femoral hernias. Here, we report on a 48-year-old female patient, known for a post-operative chronic seroma in the right groin since childhood, with a rare clinical presentation of a De Garengeot hernia. An abdominal CT-scan was performed, revealing an appendicitis with a stercolith in a femoral hernia. Generally, an inguinal approach alone (McVay procedure) is chosen and provides access for both appendectomy and hernia repair. In the absence of concomitant acute appendicitis, trans-abdominal pro-peritoneal laparoscopy (TAPP) could also be used as a single approach. In case of a rare presentation of acute appendicitis with probable contamination of the groin, we propose the double approach of laparoscopic appendectomy and hernia repair either with (if hernia sac is not opened during surgery) or without mesh. This approach is not yet described in the literature, and we think it the best technique to perform the appendectomy and hernia repair with little contamination of the groin.

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 Amyand’s Hernia Complicated by Omental Infarct Presenting as Acute Scrotum: Report of a Case and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Reza Khorramirouz ◽  
Amin Bagheri ◽  
Alireza Aalam Sahebpour ◽  
Abdol-Mohammad Kajbafzadeh
Keyword(s):  
Inguinal Hernia ◽  
Acute Appendicitis ◽  
Emergency Room ◽  
Amyand’S Hernia ◽  
Acute Scrotum ◽  
Review Of The Literature ◽  
Strangulated Hernia ◽  
Hernia Sac ◽  
Perforated Appendix

Inguinal hernia with acute appendicitis known as Amyand’s hernia is uncommon. It may clinically manifest as acute scrotum, inguinal lymphadenitis, or strangulated hernia. The presentation of Amyand’s hernia with acute scrotum has been rarely described. Also, the manifestation of infarcted omentum in the inguinal hernia has been described in one case previously. However, the coexistence of perforated appendix with infarcted omentum in the hernia sac which manifests acute scrotum has not been described previously. Herein, we described a case of a 5-year-old boy, admitted with right tense, painful, and erythematous scrotum in the emergency room. The diagnosis of herniated appendicitis was performed preoperatively by ultrasound. Moreover, the ischemic omentum was confirmed during surgery.

scholarly journals De Garengeot’s Hernia: Two Case Reports with Correct Preoperative Identification of the Vermiform Appendix in the Hernia

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Zhaosheng Jin ◽  
Muhammad Rafiz Imtiaz ◽  
Henry Nnajiuba ◽  
Suzette Samlalsingh ◽  
Akinyede Ojo
Keyword(s):  
Hernia Repair ◽  
Gold Standard ◽  
Femoral Hernia ◽  
Case Reports ◽  
Vermiform Appendix ◽  
Case Control ◽  
Case Control Studies ◽  
Intravenous Contrast ◽  
De Garengeot’S Hernia

We present two cases of incarcerated de Garengeot’s hernia. This anatomical phenomenon is thought to occur in as few as 0.5% of femoral hernia cases and is a rare cause of acute appendicitis. Risk factors include a long pelvic appendix, abnormal embryological bowel rotation, and a large mobile caecum. In earlier reports operative treatment invariably involves simultaneous appendicectomy and femoral hernia repair. Both patients were correctly diagnosed preoperatively with computed tomography (CT). Both had open femoral hernia repair, one with appendectomy and one with the appendix left in situ. Both patients recovered without complications. Routine diagnostic imaging modalities such as ultrasonography and standard CT have previously shown little success in identifying de Garengeot’s hernia preoperatively. We believe this to be the first documented case of CT with concurrent oral and intravenous contrast being used to confidently and correctly diagnose de Garengeot’s hernia prior to surgery. We hope that this case report adds to the growing literature on this condition, which will ultimately allow for more detailed case-control studies and systematic reviews in order to establish gold-standard diagnostic studies and optimal surgical management in future.

scholarly journals Inguinal hernia in a female with broad ligament cyst as content

2021 ◽  
Vol 8 (4) ◽  
pp. 1337
Author(s):  
Arul K. Chinnappan ◽  
Shanthi P. Swaminathan ◽  
Vikas Kawarat ◽  
Rajeswari Mani ◽  
Indrajit Anandakannan ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Urinary Bladder ◽  
Acute Appendicitis ◽  
Fallopian Tube ◽  
Broad Ligament ◽  
Vermiform Appendix ◽  
Lichtenstein Repair ◽  
Hernia Sac ◽  
Laparoscopic Excision ◽  
The Right

Inguinal hernia in females is relatively uncommon as compared to males. It is interesting to note that 1 male in 5 and 1 female in 50 will eventually develop an inguinal hernia in a lifetime. The hernia sac may contain unusual structures such as the vermiform appendix, acute appendicitis, ovary, fallopian tube and, urinary bladder. Here we present a case of 20-year-old female presented with complaints of swelling in the right inguinal region. Diagnosed as a case of right inguinal hernia with Broad ligament cyst as content. Managed by laparoscopic excision of cyst and then right Lichtenstein repair for inguinal hernia.

scholarly journals A féregnyúlvány diverticulosisa, diverticulitise. Esetismertetés és irodalmi áttekintés

2018 ◽  
Vol 159 (19) ◽  
pp. 768-772
Author(s):  
Tamás Vass ◽  
Attila Zaránd ◽  
Dániel Horányi ◽  
László Harsányi
Keyword(s):  
Acute Appendicitis ◽  
Preoperative Diagnosis ◽  
Histopathological Examination ◽  
Iliac Fossa ◽  
Abdominal Ultrasound ◽  
Vermiform Appendix ◽  
Review Of The Literature ◽  
Rebound Tenderness ◽  
History Of ◽  
The Right

Abstract: Diverticulitis of the vermiform appendix is a rare disease with clinical features often similar to conventional acute appendicitis. The importance of appendiceal diverticulosis is the fact that it can lead to an early and a higher incidence of perforation and therefore a higher mortality rate, in contrast to acute appendicitis alone. In this study we present the clinicopathology, diagnosis and therapy of the disease with a review of the literature. A 65-year-old woman presented to the emergency department with a 48-hour history of intermittent pain in the right iliac fossa. Abdominal ultrasound raised the possibility of acute appendicitis but because of the relative asymptomatic state of the patient, the lack of fever and rebound tenderness we started observation. After 2 days with episodic abdominal pain, the patient was taken to the operating theatre for laparoscopic exploration. Intraoperatively, multiple diverticula were noted on the appendix and appendectomy was performed. Histopathological examination revealed diverticulosis and inflammation of the appendiceal wall. Due to the possible complications, the difficult preoperative diagnosis and its frequent association with appendiceal neoplasm, appendiceal diverticulosis requires special attention. For asymptomatic cases, incidentally diagnosed intraoperatively or discovered by radiology prophylactic appendectomy is recommended. Orv Hetil. 2018; 159(19): 768–772.

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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