The presence of the appendix within a femoral hernia is rare. It was first described by the French surgeon Jacques Croissant de Garengeot in 1731. This phenomenon accounts for 0.8-1% of all femoral hernias. Acute appendicitis occurring within a femoral hernia is even rarer and is difficult to diagnose pre-operatively. This type of hernia is termed a de Garengeot hernia. The ultrasonographic and CT imaging features of de Garengeot hernias have been described previously. We report a case of a 57-year-old female who presented with a painful right-sided groin mass. She underwent MRI of the inguinal region, which successfully diagnosed this rare hernia pre-operatively. To our knowledge, this is the first description of a de Garengeot hernia diagnosed using MRI.

Volume15 Number 4

Accessory spleens occur in 10 to 30% of individuals because splenic tissue failed to fuse during embryonic life. Most commonly, accessory spleens are small oval structures near the splenic hilum or within the tail of the pancreas. Other rare locations include the walls of the stomach, intestine, greater omentum, or mesentery or in the pelvis or scrotum. We describe a case of an intrascrotal para testicular accessory spleen imaged by sonography. CASE REPORTA 47 year old man was found to have a non tender scrotal mass during an otherwise unremarkable routine physical examination. Scrotal sonography showed a left-sided, homogeneous, solid mass superior and lateral to the left testis. It measured 2 x 1.7 )( 1.5 em (Fig. lA, B). The mass was well-marginated, less echogenic than the testis, and distinct from the epididymis and testis. Color imaging showed that the mass was more vascular than the adjacent testis ( Fig. I C). The right testis was normal.During surgery, a bluish, well-circumscribed mass was found abutting the head of the left epididymis. It was easily resected without removal of the testis or epididymis.

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