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 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 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 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 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 P155 DE GARENGEOT HERNIA: A CASE REPORT

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Enrico Ferri ◽  
Melania Claudia Fanelli ◽  
Lorenzo Latham ◽  
Davide Inversini ◽  
Murad Odeh ◽  
...  
Keyword(s):  
Case Report ◽  
Femoral Hernia ◽  
Open Appendectomy ◽  
Rare Type ◽  
Hernia Sac ◽  
The Us ◽  
Direct Hernia ◽  
Surgical Options ◽  
De Garengeot’S Hernia ◽  
De Garengeot Hernia

Abstract Aim “The De Garengeot’s hernia, from Rene De Garengeot, who was the first to describe the appendix inside a femoral hernia sac in 1731, is a rare type of crural hernia. The diagnosis is challenging and surgery must be performed without delay. The incidence of appendicitis in this type of hernia is about 0.08-0.13%. The aim of this work is to describe our experience in the management of this rare subtype of hernia in a 82-year-old women” Material and Methods “A 82-year-old patient with a right groin bulge presented to the Emergency. At the physical examination the abdomen was treatable; there was no sign of bowel obstruction. Blood test values were normal, except for a high PCR value. The US of the groin region demonstrated a right femoral hernia containing a bowel tract, irreducible at the probe’s pressure. The patient underwent surgery, with diagnosis of De Garengeot’s hernia; a direct hernia repair followed by an open appendectomy were performed. The patient did not present any complications and was discharged on the second postoperative day” Results “The De Garengeot hernia is a rare entity that requires an early treatment; the preoperative diagnosis is difficult and often clinical features are similar to a common incarcerated hernia. There are many surgical options for the management of the De Garengeot hernia, but there is not a consensus for the best surgical approach” Conclusions “De Garengeot's hernia is rare, being indistinguishable from an incarcerated femoral hernia in general. This case report is about a De Garengeot’s hernia patient, who presented a good recovery after surgery.”

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.

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.

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