De Garengeot Research Articles

An Unusual Case of Femoral Hernia

The French surgeon Rene Jacques Croissant de Garengeot first described the presence of an appendix in a femoral hernia sac in 1731. We present the case of a 75-year-old lady with an incarcerated right femoral hernia which contained an appendix vermiformis. The treatment of choice of this rare disease entity is emergency surgery with simultaneous appendicectomy and repair of the femoral hernia. Suture repair or mesh repair can be used, the choice of which depends on surgeon preference, the age of the patient and the intra-operative findings (size of the hernia and the macroscopic appearance of the appendix). J Med Cases. 2016;7(6):213-215 doi: http://dx.doi.org/10.14740/jmc2499w

Acute de Garengeot Hernia Masquerading as a Recurrent Inguinal Hernia – A Diagnostic Dilemma

A de Garengeot hernia is a femoral hernia in which the sac contains the vermiform appendix. herein, we report an interesting case of a de Garengeot hernia with secondary appendicitis presenting acutely in a male patient with previous history of inguinal hernia repair. We discuss the diagnostic dilemmas involved and present a review of current literature.

De Garengeot's Hernia: Two Case Reports with Correct Preoperative Identification of the Vermiform Appendix in the Hernia.

We present two cases of incarcerated de Garengeot's hernia. This anatomical phenomenon is thought to occur in as few as 0.5% of femoral hernia cases and is a rare cause of acute appendicitis. Risk factors include a long pelvic appendix, abnormal embryological bowel rotation, and a large mobile caecum. In earlier reports operative treatment invariably involves simultaneous appendicectomy and femoral hernia repair. Both patients were correctly diagnosed preoperatively with computed tomography (CT). Both had open femoral hernia repair, one with appendectomy and one with the appendix left in situ. Both patients recovered without complications. Routine diagnostic imaging modalities such as ultrasonography and standard CT have previously shown little success in identifying de Garengeot's hernia preoperatively. We believe this to be the first documented case of CT with concurrent oral and intravenous contrast being used to confidently and correctly diagnose de Garengeot's hernia prior to surgery. We hope that this case report adds to the growing literature on this condition, which will ultimately allow for more detailed case-control studies and systematic reviews in order to establish gold-standard diagnostic studies and optimal surgical management in future.

De Garengeot′s hernia: A case description and surgical approach

Femoral hernias account for 3% of all hernias and can frequently present with incarceration of omentum, preperitoneal fat, small bowel and colon, and more rarely a Meckel's diverticulum or appendix. De Garengeot's hernia (GH) is a rare type of femoral hernia representing 1% of all femoral hernias and contains the vermiform appendix. The purpose of this report is to present a case of GH with discussion of the clinical findings along with description and details of the surgical technique applied for its repair.

De Garengeot's hernia: a surgical surprise

De Garengoet`s hernia is a femoral hernia containing the appendix. Awareness of this hernia is essential to prevent misdiagnosis and wrong choice of an operative procedure. The status of appendix dictates the choice of approach and nature of repair for the hernia. The pathophysiology, diagnosis and management of De Garengoet`s hernia is presented in this article to create an awareness of this rare hernia.

De Garengeot’s Hernia – A Diagnostic and Therapeutic Challenge

De Garengeot's hernia is an eponym for femoral hernia containing vermiform appendix as its content and is named after Rene-Jacques croissant De Garengeot after he first described the condition in 1731. We present a case of a 38-year-old woman who presented with right inguinal swelling for 15 years associated with pain and vomiting for 2 days. Clinical examination revealed an irreducible femoral hernia. Emergency surgery was done and inflamed appendix was found as content of the sac. Appendectomy followed by mesh repair was done. Standard treatment protocol does not exist owing to its rarity and the outcome depends on the time of diagnosis and treatment given. A low inguinal approach is reasonable and use of polypropylene mesh warrants further study. This article is being presented because of its rarity and intends to briefly discuss the surgical pitfalls and considerations through an up-to-date literature review.

Incidental finding of incarcerated De Garengeot hernia during laparoscopic cholecystectomy

The current case is of an 83-year-old female with vague abdominal pain found to have an incarcerated De Garengeot hernia during laparoscopic cholecystectomy with intraoperative cholangiogram. A review of the literature of this rare type of hernia will be presented in this case report.

De Garengeot's Hernia: a Diagnostic Challenge.

Surgical literature defines the case of acute appendicitis in a sac of femoral hernia as de Garengeot's hernia. The diagnosis remains a very hard challenge for surgeon because the symptoms are aspecific and the most effective tools for preoperative evaluation (as abdominal computed tomography and abdominal ultrasound scan) can often be indeterminate or misinterpreted. We report the case of an 85-year-old white male admitted to our unit complaining of a 1-day history of vague abdominal pain, nausea, vomiting, and painful swelling in the right groin. Preoperatively, an incarcerated right femoral hernia was supposed and patient underwent surgery via oblique inguinal incision. The intraoperative finding was a de Garengeot's hernia and an appendectomy with hernia repair was performed. Patient had a regular course and was discharged on the second postoperative day.

Incarcerated appendix within femoral hernia

Summary De Garengeot's hernia is a rare condition that involves acute appendicitis of an incarcerated femoral hernia. We report a 74-year-old female patient who presented with severe and painful right groin swelling. An incarcerated appendix within the femoral hernia was discovered.

De Garengeot hernia: does the time to operation matters? An analysis of our experience

De Garengeot hernia: does the time to operation matters? An analysis of our experience

De Garengeot’s hernia: Case report of appendicitis within an incarcerated femoral hernia

We present the case of a 64-year-old Caucasian female who was admitted to our emergency department with a 3-day history of a painful mass in her right inguinal area. The lump had increased in size over the previous two days and an overlying skin discoloration was also noted. With the diagnosis of an incarcerated hernia, an infrainguinal incision was carried out and a femoral hernia containing an inflamed appendix was identified, a rare condition known as de Garengeot’s hernia. This is a rather uncommon finding at surgery that is seldom diagnosed in the preoperative context.

Appendicitis in De Garengeot's Hernia Presenting as a Nontender Inguinal Mass: Case Report and Review of the Literature

Introduction. De Garengeot first described a femoral hernia containing the appendix in 1731. Appendicitis occurring in this rare clinical setting represents a challenge in diagnosis and management. Case Presentation. We present the case of a 71-year-old male with a three-day history of a nontender inguinal mass. Computed tomography (CT) suggested a femoral hernia. Intraoperatively, the hernia sac was noted to contain a perforated appendix. Discussion. This is an infrequently reported clinical scenario and only the 14th reported case in peer-reviewed literature which includes preoperative CT images. Our case adds to previously reported low sensitivity of CT for diagnosing De Garengeot's hernia. Furthermore, unlike our case the vast majority of previous reports noted a painful inguinal swelling. Conclusion. Perforated appendicitis in a femoral hernia is an extremely uncommon presentation. However, consideration should be given to De Garengeot's hernia in patients with a groin mass, even if nontender.

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

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.

De Garengeot's hernia: a case of acute appendicitis in a femoral hernia sac

The presence of an appendix vermiformis in a femoral hernia sac is called De Garengeot's hernia. It is a very rare clinical condition and requires emergency surgery. However, preoperative diagnosis of De Garengeot's hernia is difficult. Herein, we report a 58-year-old female who presented with sudden-onset painful swelling in the right groin region. Diagnosis was established based on computed tomography findings, and appendectomy with mesh-free hernia repair was performed. The postoperative period was uneventful, and the histopathologic examination of the specimen revealed gangrenous appendicitis.

De Garengeot Hernia: A Case Report and Review of Literature

Femoral Hernia constitutes a small percentage of groin herniae,but have always been associated with significantly high morbidity.This is partly due to the difficulties in diagnosing the hernia and also due to its propensity for incarceration because of its anatomy. We report a rare case of De Garengeot Hernia which is the herniation of the appendix into a femoral hernia.While this is rare in itself,acute appendicitis in a strangulated femoral hernia is even more uncommon.

Case 187: De Garengeot Hernia

De Garengeot hernia is rare, and several imaging characteristics may be seen that enable accurate diagnosis.

De Garengeot’s hernia: a comprehensive review

Acute appendicitis within a femoral hernia is a rare condition that was first described by Rene Jacques de Garengeot. In the present study, we summarize the existing evidence on de Garengeot's hernia, with special emphasis on its clinical presentation and diagnostic approach. A thorough search of the English-language literature published between 1980 and 2011 was performed. Studies reporting cases of de Garengeot's hernia were selected using specific inclusion criteria (description of femoral hernia appendicitis, statement of patient demographics and symptoms, and statement of diagnostic tests performed). Thirty-one studies that encompassed 36 patients (28 women, mean age 71.5years) with de Garengeot's hernia were included in our analysis. Patients presented with a right groin mass in 35 (97%) cases. The mass was almost always painful (n=35, 97%), while 14 (39%) of the patients were febrile. Mean duration of symptoms was 5.17days. Fifty-six percent of the groin masses were erythematous. Leukocytosis was present in 67% of the patients, and 25 patients underwent imaging investigation with X-ray (n=11), Ultrasound (n=5) or Computed Tomography (CT, n=9). Twenty percent of the Ultrasound and 44% of the CT studies were diagnostic, leading to an overall rate of 14% of femoral hernia appendicitis preoperative diagnosis. Eighty-one percent of the patients underwent herniorrhaphy with sutures while a mesh was used in 19%. Mean hospital stay was 6.23days. Preoperative diagnosis of de Garengeot's hernia is difficult due to its atypical clinical presentation. Further surgical treatment depends on the surgeon's sound clinical judgment.

The MRI findings of a de Garengeot hernia

The presence of the appendix within a femoral hernia is rare. It was first described by the French surgeon Jacques Croissant de Garengeot in 1731. This phenomenon accounts for 0.8-1% of all femoral hernias. Acute appendicitis occurring within a femoral hernia is even rarer and is difficult to diagnose pre-operatively. This type of hernia is termed a de Garengeot hernia. The ultrasonographic and CT imaging features of de Garengeot hernias have been described previously. We report a case of a 57-year-old female who presented with a painful right-sided groin mass. She underwent MRI of the inguinal region, which successfully diagnosed this rare hernia pre-operatively. To our knowledge, this is the first description of a de Garengeot hernia diagnosed using MRI.

Clinical significance of de Garengeot's hernia: A case of acute appendicitis and review of the literature

IntroductionThe presence of the appendix in a femoral hernia sac is known as de Garengeot's hernia. We report a rare case of an elderly woman with femoral hernia appendicitis and discuss the surgical pitfalls and considerations through a literature review. Presentation of caseAn 83-year-old woman presented with fever and right lower quadrant abdominal pain. Clinical examination revealed a femoral hernia. Ultrasonography confirmed bowel was present in the hernia sac. In the operation room, an acutely inflamed appendix was recognized within the sac. The patient underwent appendectomy and hernia repair with sutures. DiscussionAcute appendicitis within a femoral hernia is rare and multiple dilemmas exist regarding its treatment. An incision below the inguinal ligament is a reasonable choice in order to access the hernia sac. A mesh should be placed in non-infectious appendectomy while herniorrhaphy is preferred in cases of appendicitis. ConclusionThe presence of the vermiform appendix in a femoral hernia sac is rare but the surgeon should be aware of this clinical entity. Prompt diagnosis and appropriate surgical treatment is the key to avoid complications.

De Garengeot's hernia in a 60-year-old woman: a case report

IntroductionDe Garengeot first described the presence of the appendix within a femoral hernia in 1731.Case presentationWe report the case of a 66-year-old Caucasian woman who presented with acute appendicitis within an incarcerated femoral hernia. This is the first reported case of de Garengeot's hernia in the Balkan area.ConclusionsAppropriate management without incurring any delay for radiological imaging can be promising for an uneventful postoperative course. The treatment of choice of this disease entity is emergency surgery and consists in simultaneous appendectomy through the hernia incision and primary hernia repair. In patients with large hernia defects or in older people the use of mesh for repairing the hernia defect can be an excellent choice.