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.
Popliteal artery aneurysms (PAA) are the commonest arterial aneurysm of the periphery. It is defined as focal dilation more than 50% of the normal vessel diameter, which usually varies between 7 and 11 mm. The most common presentation for PAA is claudication due to luminal stenosis caused by mural thrombus or acute limb ischaemia due to thromboembolism. It is much less common for patients to present with mass effect symptoms due to compression of adjacent structures, and of these, common peroneal nerve compression is particularly uncommon. We present a rare case of a 92-year-old female presenting with 4-month history of left foot drop with radiological evidence of common peroneal nerve compression secondary to PAA measuring 22 × 21 mm in size. To the best of our knowledge, this is the smallest reported popliteal aneurysm presenting with foot drop. We also present the endovascular treatment option used.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.