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.
Small intestine cancers account for 1-3% of all gastrointestinal tumors, with only 11-25% of these tumors located in the jejunum. We report the case of a woman who has been experiencing abdominal pain for the last six months, accompanied by nausea, vomiting and appearance of dark-colored stools, who has lost 20 kg in weight during the last few months. Laboratory findings indicated anemia and no significant changes were identified in the abdominal ultrasound. By endoscopic examination of the stomach and duodenum and by colonoscopy, no infiltrations were found. Serum markers were elevated and CT scan of the abdomen showed thickening of a part of the jejunum wall with swollen lymph nodes in the mesentery, along the inferior vena cava and abdominal aorta, in the retroperitoneal space. By opening the abdominal cavity, we observed an infiltration in the initial part of the jejunum with an infiltration of the entire wall. Resection of the jejunum with related mesenthery, vessels and lymph nodes therein was performed. Histopathology revealed an invasive adenocarcinoma of the small intestine, with an invasion of all layers of the wall and mesentery. Adjuvant FOLFOX chemotherapy was introduced, 6 cycles in total, and following each cycle, tumor markers have been constantly decreasing. No relapse has been identified after nine months. Due to often deep position in the small intestine, atypical symptomatology and lack of screening, an early diagnosis is difficult. Surgical resection of the affected small intestine followed by an additional chemotherapy is the optimal treatment strategy.
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