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 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 De Garengeot Hernia: Case Report and Review of the Literature of a Rare Femoral Hernia

2021 ◽  
Author(s):  
Leo Licari ◽  
Sofia Campanella ◽  
Claudia Carolla ◽  
Simona Viola ◽  
Giuseppe Salamone
Keyword(s):  
Femoral Hernia ◽  
Abdominal Cavity ◽  
Fluid Collection ◽  
Rare Condition ◽  
Hernia Sac ◽  
Blind Ending ◽  
Tender Mass ◽  
Operative Findings ◽  
The Right ◽  
De Garengeot Hernia

AbstractDe Garengeot hernia is a rare femoral hernia defined as the presence of the appendix within the femoral hernia sac. The incidence of appendicitis in this type of hernia is a rare condition that accounts for 0.08–0.13% of all De Garengeot hernias. We describe the case of a 61-year-old woman that presented at the emergency department with a tender mass (diameter 10 × 8 cm) in the right groin region for 5 days associated with pain in lower right abdomen and accompanied by fever (38 °C). Computed tomography (CT) of the abdomen revealed the presence of a complex fluid collection with small foci of air in the right inguinal region, measuring 9 × 7 × 10 cm in the 3 orthogonal dimensions and a blind ending tubular structure extending from the caecal base into the groin mass through a narrowed neck defect, medial to the common femoral vessels. The CT scan demonstrated the suspected diagnosis of De Garengeot hernia complicated by acute appendicitis. The intra-operative findings confirmed the diagnosis. The patient was successfully managed operatively. The surgical strategy took into account the need to significantly reduce the diffusion of the infection inside the abdominal cavity. The patient was discharged on the fifth postoperative day without peri-/postoperative complications.

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 Perforated Meckel’s Diverticulitis in a Patient with Unknown Intestinal Malrotation: Clinical Pitfall

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Marie Burgard ◽  
Floryn Cherbanyk ◽  
François Pugin ◽  
Bernhard Egger
Keyword(s):  
Acute Appendicitis ◽  
Clinical Presentation ◽  
Final Diagnosis ◽  
Intestinal Malrotation ◽  
Radiological Imaging ◽  
Atypical Clinical Presentation ◽  
Lower Abdominal Quadrant ◽  
Meckel’S Diverticulitis ◽  
The Right ◽  
Abdominal Quadrant

Symptomatic Meckel’s diverticulum is rare in adults. The most frequent complications are intestinal obstruction and diverticulitis. Diagnosis of Meckel’s diverticulitis can be challenging due to nonspecific clinical manifestation of pain in the right lower abdominal quadrant, mimicking acute appendicitis. If associated with congenital malformation, such as intestinal malrotation, the anomalous anatomy makes the diagnosis even more challenging. In such cases, radiological imaging is essential to guide further management. We present a case of Meckel’s diverticulitis in which physicians were initially misguided because of the atypical clinical presentation. Yet, anamnestic details directed to a potential underlying malformation, leading to supplementary radiological examination and the final diagnosis.

Appendiceal Diverticulitis

2006 ◽  
Vol 72 (3) ◽  
pp. 221-223 ◽  
Author(s):  
Hamed Kabiri ◽  
Leon E. Clarke ◽  
Chris D. Tzarnas
Keyword(s):  
Acute Appendicitis ◽  
Clinical Presentation ◽  
Correct Diagnosis ◽  
Younger Patients ◽  
Clinical Process ◽  
Lower Abdominal Quadrant ◽  
Appendiceal Diverticulitis ◽  
The Right ◽  
Time Of Operation ◽  
Abdominal Quadrant

The incidence of appendiceal diverticulitis in pathologic specimens is 0.004 to 2.1 per cent and is unusual in younger patients. Despite being first described in 1893, this condition is commonly dismissed by surgeons and pathologists as a variant of true appendicitis. However, appendiceal diverticulitis is a discrete clinical process that must be considered in the appropriate setting because of the much higher risk of perforation. The average age is older, the pain is often intermittent, and although it can be localized in the right lower abdominal quadrant, it is of longer duration. Although no further treatment in addition to appendectomy is needed, it is important that surgeons be aware of this condition, as the clinical presentation can be different from the classical acute appendicitis picture. Patients often seek medical treatment much later than those with classic appendicitis, and if there is a delay in establishing the correct diagnosis, perforation within the mesentery is found at the time of operation. Also, it is often mistakenly identified as carcinoma and it has higher rate of perforation and a longer convaslescence. We describe a case of a 42-year-old man and review the literature.

scholarly journals Acute appendicitis: a 2- year review of clinical presentation and histopathology

1970 ◽  
Vol 1 (2) ◽  
pp. 104-107 ◽  
Author(s):  
N Subedi ◽  
US Dangol ◽  
MB Adhikary ◽  
S Pudasaini ◽  
R Baral
Keyword(s):  
Acute Appendicitis ◽  
Clinical Diagnosis ◽  
Clinical Presentation ◽  
Histopathological Examination ◽  
Iliac Fossa ◽  
Operative Procedure ◽  
Lymphoid Hyperplasia ◽  
Negative Appendectomy ◽  
Histopathological Correlation ◽  
The Right

Background: Acute appendicitis is the most common surgical emergency. Obstruction of the lumen by fecolith is the usual cause of acute appendicitis.The aim of the study was to analyze clinical presentation of acute appendicitis and its histopathological correlation. Materials and Methods: A retrospective study of acute appendicitis was done in the Department of Surgery of Helping Hands Community Hospital from January 2009 to December 2010. Three hundred forty five patients out of 415 patients with clinical diagnosis of appendicitis underwent operative treatment. The histopathological reports were reviewed and correlated with clinical diagnosis. Results: Out of 345 patients who underwent operative procedure 98% (n= 338) came with chief complaint of pain in the periumbilical region migrating to the right iliac fossa. The mean age of presentation was 42 years. Increased leucocyte count was seen in only 65% cases. Acute appendicitis was more commonly seen in male patients (214 cases, 62%). The most common per operative finding was acutely inflammed appendix (84%) followed by perforated appendix (7.5%), gangrenous appendix (3.5%) and appendicular lump (1.5%). However, histopathological diagnoses were acute appendicitis (91.9%), resolving appendicitis (3.5%), lymphoid hyperplasia (2.6%), mucocele (0.3%) and carcinoid (0.3%). Normal histology was seen in 1.4% cases. Conclusion: Though there are other causes of acute abdomen, acute appendicitis still stands first amongst all the emergencies. Histopathological examination of appendectomy specimen should not be omitted in order to see the incidence negative appendectomy rate and to avoid complications relating to malignant conditions. Keywords: Acute appendicitis; Appendectomy; Appendicular perforation; Histopathology DOI: http://dx.doi.org/10.3126/jpn.v1i2.5402 JPN 2011; 1(2): 104-107

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.

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