De Garengeot hernia: Case report and review

Abstract

Introduction: Rene De Garengeot, a French surgeon, was the first to describe the presence of the appendix inside a femoral hernia sac in 1731. It is a rare entity that has fewer than 100 cases reported in literature.

Presentation of case: An 86 years-old male patient, comes to Emergency Department complaining of painful bulging in the right inguinal region, associated with local inflammatory signs. He was initially diagnosed as incarcerated femoral hernia and underwent emergency open surgery. Inguinotomy was performed and after hernia sac dissection it was possible to observe the presence of the appendix incarcerated in its interior, without clinical signs of appendicitis. Surgeons performed appendectomy and inguinal repair of the femoral hernia with placement of a polypropylene mesh.

Discussion: De Garengeot hernia is a rare entity that requires early treatment in order to avoid possible complications. When facing a patient with incarcerated hernia emergency surgery must be indicated even if it is not possible to determine the contents of the hernia.

Conclusion: This paper presents a case report of a De Garengeot hernia patient who presented a good evolution after surgery.

Keywords: De Garengeot hernia; Incarcerated femoral hernia.

Fig. 1

Physical evaluation–groin bulge with inflammatory signs.

Fig. 2

Intraoperatory– (A) pubis, (B) illiac crest, (C) inguinal ligament, (D) hernia sac, and (E) appendix.