A rare case of De Garengeot hernia: CT findings

Abstract

We report a case of "De Garengeot's hernia" (DGH), a rare condition that occurs when the inflamed appendix is localized inside a femoral hernia. The appendix may be involved in inflammatory or necrotic processes and the treatment is emergency surgery. It is usually discovered by chance during surgery. It occurs in 0.5%-5% of all femoral hernias. In 0.08%-0.13% of cases, the appendix can present inflammatory or necrotic processes due to the narrowness of the neck of the femoral canal; in these cases, an emergency surgery is required through a no standard surgical procedure. In the other cases, it is usually found accidentally during surgical repair of the hernia or more rarely diagnosed preoperatively by CT. Therefore, the purpose of our study is to report a case of DGH describing CT main findings in order to improve the preoperative diagnosis.

Keywords: Amyand hernia; De Garengeot hernia; appendicitis; appendix; computed tomography; femoral; hernia; inguinal.

Figure 1.

(A) CT axial scan of the abdomen shows dilated appendix (white arrow) in right femoral hernia (red arrow) with signs of inflammation of the surrounding fat. (B) MPR coronal reconstruction shows the appendix (white arrow) as a tubular structure extending from the caecal base within a right femoral hernia (red arrow), (C) MPR sagittal reconstruction shows the extension of the right hernia sac within the femoral (white arrow).

Figure 2.

A femoral hernia containing the appendix during surgery through an open approach.