The de Garengeot hernia chicken-and-egg conundrum: Acute appendicitis in an incarcerated femoral hernia, but which came first? A case report. | LitMetric
Department of Surgery, Wollongong Hospital, Wollongong, New South Wales, Australia; Department of Surgery, Shoalhaven District Memorial Hospital, Nowra, New South Wales, Australia; Graduate School of Medicine, University of Wollongong, Keiraville, New South Wales, Australia.
Published: August 2023
AI Article Synopsis
Article Abstract
Introduction: De Garengeot hernia is exceedingly rare and denotes a femoral hernia containing the appendix, which may or may not be inflamed. Given its low incidence, there is no clear consensus on the ideal surgical management of a de Garengeot hernia.
Presentation Of Case: This is a case report of an 81-year-old man who was admitted and operated on for a strangulated femoral hernia containing an inflamed appendix. Appendicectomy and primary hernia repair were performed in tandem using a single incision.
Discussion: The case presented here provides a unique account of a subacute presentation of a de Garengeot hernia. It draws into question the true pathogenesis of appendicitis in this clinical setting, by lending credence to the theory that appendicitis can arise sporadically within a long-standing de Garengeot hernia, given the subacute-on-chronic nature of the patient's presentation. Furthermore, the case presented herein represents the minority of cases in which the diagnosis is clinched preoperatively based on computer tomography imaging as, in the vast majority of cases, definitive diagnosis is not made until the time of operation.
Conclusion: Due to the lack of prospective studies and randomised controlled trials, a standardised, evidence-based approach for the optimal surgical management of de Garengeot hernias remains elusive. Early recognition and diagnosis as well as an individualised approach that considers the patient's anatomy and clinical status are crucial to the management of De Garengeot hernias.
De Garengeot's hernia, a femoral hernia containing an incarcerated appendix, is rarely encountered in clinical practice. We report a case of a 62-year-old woman presenting with a right groin lump. A computed tomography scan reported a right inguinal hernia containing fluid with no bowel involvement.
* A 63-year-old woman was treated for this condition after presenting with a painful groin lump; surgery revealed an inflamed appendix and allowed for both an appendectomy and hernia repair.
* Effective diagnosis is difficult, often confused with other issues, and early surgical intervention is key to preventing complications and ensuring proper recovery.
De Garengeot hernia is a rare occurrence characterised by the presence of the appendix within a femoral hernia. This type of hernia is notable for its rare anatomical presentation. In rare instances, the appendix can present as inflamed or necrotic in which case it may present as an emergency.
Introduction: De Garengeot hernia is a rare subset of femoral hernias containing the vermiform appendix. It is more common in females. The presenting symptoms are non-specific hence diagnosis is challenging and there is no consensus on treatment of it.
