De Garengeot appendicitis

Abstract

An 87-year-old woman presented with a 1-day history of an enlarging right groin lump with associated localized pain. She had a history of hypertension managed with perindopril. On examination, she had a low-grade fever with a temperature of 37.9 degrees Celsius, was mildly hypotensive with a blood pressure of 97/60mmHg, borderline tachycardic with a heart rate of 95 beats per minute, and was saturating at 95% on room air. On palpation, there was an irreducible and tender lump in her right groin. She was not peritonitic. Her white cell count was elevated at 11.6 × 109/L, and her C-reactive protein was elevated at 20 mg/L. She underwent computed tomography (CT) of the abdomen and pelvis. On review of the imaging (Figure 1), which diagnosis explains this patient’s acute presentation? •Littre hernia with Meckel’s diverticulitis •De Garengeot hernia with appendicitis •Saphena varix •Pantaloon hernia