De Garengeot's hernia: a case of acute appendicitis in a femoral hernia sac

Abstract

The presence of an appendix vermiformis in a femoral hernia sac is called De Garengeot's hernia. It is a very rare clinical condition and requires emergency surgery. However, preoperative diagnosis of De Garengeot's hernia is difficult. Herein, we report a 58-year-old female who presented with sudden-onset painful swelling in the right groin region. Diagnosis was established based on computed tomography findings, and appendectomy with meshfree hernia repair was performed. The postoperative period was uneventful, and the histopathologic examination of the specimen revealed gangrenous appendicitis.

De Garengeot's hernia: our experience of three cases and literature review

“…This is in keeping with the increased incidence of the femoral herniae in women 7. The mean age at presentation is reported as 55 years 5 8. It has been suggested that pregnancy related changes may account for the increased incidence of this condition in women 7.…”

“…The incidence of this is reported in literature between 0.8 and 1% 5 – 7. The presence of acute appendicitis within a femoral hernia is even rarer, occurring in 0.08–0.5% of the femoral herniae 6 – 8. This finding is termed De Garengeot's hernia 5.…”

“…The findings on CT are often difficult to detect and can be non-specific. However, the presence of a low lying caecum in combination with the finding of a tubular structure within the femoral hernia and stranding of adjacent fat is reported to have sensitivity and specificity up to 98% in achieving diagnosis 2 4 5 8. In a recent case, MRI was used for preoperative diagnosis as an alternative to CT in a patient with a contrast allergy and is reported to have comparable sensitivity and specificity 5.…”

De Garengeot’s Hernia: Report of a Rare Surgical Emergency and Review of the Literature

“…After the year 2000, a total of 32 articles, which presented 34 cases of de Garengeot’s hernia and histology proven appendicitis have been published ( 1, 3, 5 – 34 ). Thirty-four patients (5 men and 29 women) with a mean age of 71.2 years with this uncommon type of hernia were presented in these studies.…”

De Garengeot's hernia: an unusual case on call

“…Femoral hernias account for <5% of all hernias and are more common in women with increasing incidence with age,2 and a female to male ratio of 3:1 3. The finding of the appendix within a femoral hernia has a reported incidence of 0.5–5% 4 5.…”