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

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).

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

Journal of Surgical Case Reports ◽

10.1093/jscr/rjz142 ◽

2019 ◽

Vol 2019 (5) ◽

Cited By ~ 2

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.

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

Journal of Surgical Case Reports ◽

10.1093/jscr/rjz287 ◽

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.

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

Journal of International Medical Research ◽

10.1177/03000605211028409 ◽

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.

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Unusual presentation of De Garengeot hernia

BMJ Case Reports ◽

10.1136/bcr-2019-230455 ◽

2019 ◽

Vol 12 (7) ◽

pp. e230455 ◽

Cited By ~ 1

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.

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Left Sided Amyand’s Hernia with Sliding Component

Journal of Nepal Medical Association ◽

10.31729/jnma.577 ◽

2013 ◽

Vol 52 (189) ◽

pp. 285-287 ◽

Cited By ~ 7

Author(s):

Ashis Pun ◽

Roshan Khatri

Keyword(s):

Clinical Practice ◽

Inguinal Hernia ◽

Acute Appendicitis ◽

Rare Case ◽

Vermiform Appendix ◽

Amyand’S Hernia ◽

Hernia Sac ◽

Disease Condition ◽

Amyand Hernia ◽

Hernial Repair

The eponym ‘Amyand hernia’ coined in recognition of Claudius Amyand, the first surgeon to successfully perform appendectomy in a hernia sac containing appendix, refers to the vermiform appendix within inguinal hernia. Here, we present a rare case, of Amyand’s hernia in an 18 month-old boy who was brought with an inguino-scortal swelling which later on exploration was left sided Amyand’s hernia with sliding component. Amyand’s hernia is not very often seen in the clinical practice and its pre-operative diagnosis is very difficult hence awareness of this disease condition is essential for preoperative suspicion and even diagnosis of the condition. Keywords: Amyand’s hernia; acute appendicitis; hernial repair.

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

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa164 ◽

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.

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

BMJ Case Reports ◽

10.1136/bcr-2019-232419 ◽

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.

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Plasmacytoid variant of urothelial carcinoma: two rare case reports

10.26226/morressier.5b4709866f4cb300109517fc ◽

2018 ◽

Author(s):

Sofia Mavropoulou ◽

Zoi Tatsiou

Keyword(s):

Urothelial Carcinoma ◽

Rare Case ◽

Case Reports

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Linezolid Induced Skin Reactions in a Multi Drug Resistant Infective Endocarditis Patient: A Rare Case

Current Drug Safety ◽

10.2174/1574886315666200516175053 ◽

2020 ◽

Vol 15 (3) ◽

pp. 222-226 ◽

Cited By ~ 1

Author(s):

Asha K. Rajan ◽

Ananth Kashyap ◽

Manik Chhabra ◽

Muhammed Rashid

Keyword(s):

Case Report ◽

Infective Endocarditis ◽

Rare Case ◽

Case Reports ◽

Multidrug Resistant ◽

The Body ◽

Prior History ◽

Skin Reactions ◽

Rare Case Report ◽

Multiple Drugs

Rationale: Linezolid (LNZ) induced Cutaneous Adverse Drug Reactions (CADRs) have rare atypical presentation. Till date, there are very few published case reports on LNZ induced CADRs among the multidrug-resistant patients suffering from Infective Endocarditis (MDR IE). Here, we present a rare case report of LNZ induced CARs in a MDR IE patient. Case report: A 24-year-old female patient was admitted to the hospital with chief complaints of fever (101°C) associated with rigors, chills, and shortness of breath (grade IV) for the past 4 days. She was diagnosed with MDR IE, having a prior history of rheumatic heart disease. She was prescribed LNZ 600mg IV BD for MDR IE, against Staphylococcus coagulase-negative. The patient experienced flares of cutaneous reactions with multiple hyper-pigmented maculopapular lesions all over the body after one week of LNZ therapy. Upon causality assessment, she was found to be suffering from LNZ induced CADRs. LNZ dose was tapered gradually and discontinued. The patient was prescribed corticosteroids along with other supportive care. Her reactions completely subsided and infection got controlled following 1 month of therapy. Conclusion: Healthcare professionals should be vigilant for rare CADRs, while monitoring the patients on LNZ therapy especially in MDR patients as they are exposed to multiple drugs. Moreover, strengthened spontaneous reporting is required for better quantification.

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