De Garengeot's Hernia: A rare presentation of an ischemic appendix within a strangulated femoral hernia in an elderly male

Keshav Swarnkar,Wahid Abdul,Charlotte Thomas

doi:10.5348/ijcri-2014145-cr-10456

Abstract

Introduction: De Garengeot’s hernia; the presence of a vermiform appendix in the femoral hernia sac, is a rare occurrence. Due to the paucity of cases and no large case series yet published, the incidence of De Garengeot’s hernia is reported between 0.5–5%. Femoral hernias account for less than 5% of all groin hernias and are three times more common amongst females and amongst the elderly. We report an unusual case of an 84-year-old male patient with a strangulated femoral hernia sac containing an ischemic appendix.

Highlights

De Garengeot’s hernia; the presence of a vermiform appendix in the femoral hernia sac, is a rare occurrence
We report an unusual case of an 84-year-old male patient with a strangulated femoral hernia sac containing an ischemic appendix
Case Report: An 84-year-old male presented to the emergency department with a 48 hour history of an increasingly painful right-sided groin swelling

Summary

INTRODUCTION

The incidence of acute appendicitis in the general population during their lifetime is approximately 7% [1, 2]. The presence of a vermiform appendix in a femoral hernia sac is very uncommon with an estimated incidence between 0.5–5%, whilst appendicitis in a femoral hernia. We report an unusual case of an 84-year-old male patient with a strangulated femoral hernia sac containing an ischemic appendix. An 84-year-old male was presented to accident and emergency department complaining of a two-day history of increasing, constant right groin pain and swelling. The patient began to experience nausea, vomiting and poor appetite prior to the onset of pain He noticed he had not opened his bowels for three days and was unsure whether he was passing flatus which was unusual for him. The femoral canal was explored and incidentally an incarcerated femoral hernia sac containing an ischemic appendix was identified (Figure 1). Histopathology report confirmed atrophic and ischemic changes of the appendix

Findings

DISCUSSION

CONCLUSION