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.
Introduction. De Garengeot?s hernia is a rare type of femoral hernia that
contains the appendix within the hernia sac and it is found in 0.5-5% of
cases. The incidence of appendicitis within the de Garengeot?s hernia is
0.08-0.13%. We present a case of de Garengeot?s hernia with a gangrenous
appendicitis and an extensive literature review of published cases. Case
Report. We present a case of a 68-year-old woman who underwent urgent
surgery due to an incarcerated femoral hernia and preoperatively undiagnosed
de Garengeot?s hernia with a gangrenous appendicitis within the femoral
hernia sac. Conclusion. De Garengeot?s hernia is most commonly diagnosed
intraoperatively and requires immediate surgery in order to avoid
complications. There are no recommendations regarding the choice of surgical
procedure for femoral defect repair.
We describe a case of a 70-year-old female who presented with pain and swelling in her right groin. CT scan of the abdomen and pelvis found Amyand’s hernia with evidence of inflammation of the appendiceal tip consistent with appendicitis. Laparoscopic appendectomy and open hernia repair revealed an incarcerated hernia. Using blunt dissection, the inflamed tip of the appendix was found in the femoral canal. The appendix was removed. The patient had a De Garengeot’s hernia, not the Amyand’s hernia initially suspected. Patient was discharged home the following day.
De Garengeot’s hernia, the presence of an incarcerated vermiform appendix within a femoral hernia, is a rare general surgery emergency that predominantly affects elderly female patients. Due to its rarity, there is significant variation in surgical technique; however, most case reports favor an open approach. Here we present a case of a De Garengeot’s hernia with a unique hybrid open and laparoscopic repair, utilizing the hernia defect as a port site. We will also review the relevant literature.
De Garengeot’s hernia with appendicitis—a rare cause of an acutely painful groin swelling
