P-012 GARENGEOT'S HERNIA WITH ACUTE APPENDICITIS: A RARE CASE

Abstract

Abstract Garengeot's hernia is a rare entity that refers to the herniation of the vermiform appendix through the femoral canal, being even rarer the presence of acute appendicitis in a Garengeot hernia as presented in the clinical case, with an overall incidence of 0,08%-0,13%. A 52 years old female patient, attended the Emergency Service complaining of abdominal pain in the right lower quadrant and fever for the last 2 days. As pathological background, she had bilateral tubal ligation, right crural hernioplasty and iatrogenic uterine perforation after placement of a intrauterine device (IUD). On physical examination, she complained of pain in iliac fossa/right inguinal region showing a positive Blumberg sign. Abdominal ultrasonography revealed acute appendicitis. In the laparoscopic approach, we identified the ileocecal appendix contained in a right crural hernia with abscessed acute appendicitis. We proceeded with appendectomy and, given the soiling of operative field, we chose not to correct the hernia at that moment. Empirical antibiotic therapy with Amoxicillin/Clavulanic acid was performed and patient was discharged after 3 days. Diagnosis of Garengeot hernia with acute appendicitis is difficult, being more frequently diagnosed intraoperatively. There's no standard therapeutic approach regarding hernia repair simultaneously, being licit not to do it due to the risk of postoperative infection.