The MRI findings of a de Garengeot hernia

Abstract

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.

Figure 1

A coronal image of the pelvis using true fast imaging with steady-state precession. The image demonstrates a tubular abnormality in the right inguinal region (arrow). High signal fluid is seen to surround a low signal linear structure which was thought to represent the appendix. This was confirmed at surgery to be an inflamed appendix in the femoral canal. The focal area of low signal area within the high signal abnormality was believed to represent air.

Figure 2

An axial image of the pelvis using true fast imaging with steady-state precession. The image demonstrates an area of high signal surrounding a low signal tubular structure (arrow). Its relationship to the femoral vessels led to the pre-operative suggestion that it represented an inflamed appendix lying within the femoral canal.