Images in Clinical Medicine from The New England Journal of Medicine — De Garengeot’s Hernia. De Garengeot hernias are femoral hernias that contain the appendix. It is a rare phenomenon, with only 1% of all femoral hernias containing the appendix (and. De Garengeot hernia should be suspected in an elderly woman presenting with signs and symptoms of a strangulated hernia. The differential.

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A recurrent, incarcerated inguinal hernia was suspected, but the lack of systemic or abdominal symptoms and the absence of findings suggesting bowel obstruction was concerning. Published online Jan 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. Strangulated femoral hernia containing a perforated appendix.

However, there have been cases where the hernial sac and the appendix are reduced into the peritoneal cavity via midline laparotomy.

De Garengeot hernia: Case report and review

Open Med 11 1: Table 1 Table 1. This case reports an elderly man with herniw hernia diagnosed with De Garengeot hernia intraoperatively and submitted to open inguinal hernia repair with mesh and appendectomy trough the inguinotomy at same surgical procedure. The primary concern was for an incarcerated, recurrent inguinal hernia resulting in tissue necrosis and abscess formation. Abdominal enhanced computed tomography imaging showing a the enhanced tubular structure in the femoral hernia and b the caecum.


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.

Although it would be preferable not to use a mesh in a patient with well-documented inflammation, successful repair with mesh has been reported. Both patients were correctly diagnosed preoperatively with computed tomography CT.

Appendectomy and primary hernia repair should be performed simultaneously. Login Register Login using. Indian J Garegneot 75 Suppl 1: The appendectomy through the hernia sac in a single surgical procedure is an accepted approach but laparoscopy remains controversial [8].

To the best of our knowledge, this approach has never been described before. A record of sixteen personal cases. Thus, we recommend different incision approaches, as applied in our case, or interval hernioplasty, especially in patients with concurrent appendicitis.

A case of De Garengeot hernia and literature review. A mobile caecum, large caecum dw visceroptosis is also considered a risk factor for de Garengeot hernia [ 14 ].

With increasing published case reports it may be possible to systematically review the cases and reach a consensus as to what the optimal surgical management may be. The patient was taken to theatre for a right sided exploration and hernia repair under general anaesthesia.

Hernia of the vermiform appendix. The French and their hernias: A 56 year old male Caucasian patient was admitted to the Emergency Department of our Hospital due to an irreducible lump in his right groin, which he had initially noticed 12 h earlier. Patients may present fever, signs and symptoms that suggest obstructive acute abdomen and laboratorial exams may show non-specific results [8]. A case report of a de Garengeot hernia in a nonagenarian veteran. The preoperative diagnosis of de Garengeot hernia was known to be difficult.


Carolina Talini — literature review, data analysis, writing. When facing a patient with incarcerated hernia, emergency surgery must be indicated.

Conclusion De Garengeot hernia is a rare entity that requires early treatment in herina to avoid complications. Appendiceal diverticulitis in a femoral hernia causing necrotizing fasciitis of the right inguinal region: Due to the vestigial nature of the appendix, strangulation does not result in mechanical obstruction, although ileus can occasionally develop secondary to inflammation.

De Garengeot Hernia

Surgical management of de Garengeot hernia is controversial. Support Center Support Center. A Irreducible lump in the right groin with overlying erythema. This rare hernia usually presents with both diagnostic and therapeutic dilemmas.

Please review our privacy policy. Abstract Background and Objectives: Physical examination revealed a small irreducible palpable lump with overlying skin erythema and local tenderness in the right inguinal region Figure 1A.

Int J Surg Case Rep 2 5: The patient went home on day one after the operation. Discussion De Garengeot hernia is a rare entity that requires early treatment in order to herniia possible complications. This paper presents a case report of a De Garengeot hernia patient who presented a good evolution after surgery.