De Garengeot's hernia in an elderly woman as a diagnostic challenge: a review of literature

Abstract

De Garengeot's hernia is the presence of an appendix in a femoral hernia and can be a rare cause of an acute groin swelling. Here, we present a case report of an elderly woman who was referred to us with a short history of a painful, tender lump in the right groin associated with nausea and vomiting. Her inflammatory markers were raised, and to establish a final diagnosis, an urgent CT scan was requested which showed a blind ending tubular structure in a hernia sac. She was taken to the theatre for urgent exploration of the groin which revealed that it was a femoral hernia, the sac of which contained gangrenous appendix, the base of which could not be accessed through the groin incision and, therefore, a lower midline laparotomy incision was made and a formal appendicectomy was done.

Keywords: gastrointestinal surgery; general surgery.

Figure 1

Axial image demonstrating a right groin hernia below the level of the pubic tubercle which contains a tubular structure, most probably appendix.

Figure 2

Coronal image demonstrating a right-sided femoral hernia which contains an inflamed distal appendix and surrounding oedema. This image shows the tubular hernia content to be attached to the lower pole of the caecum.

Figure 3

Sagittal image demonstrating a right-sided femoral hernia which contains an inflamed distal appendix. The tubular content of the hernia sac appears to be attached to the lower pole of the caecum.