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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The patient made an uneventful recovery and went home after two days. We were also able to anticipate the contents of the hernia before opening the sac. Treatment consists of emergency surgery. However, the treatment for garengeoot condition along with acute appendicitis is still controversial.

These patients seldom develop signs of peritonitis, as the inflamed appendix is isolated from the peritoneal cavity by the tight neck of the hernia sac. Some authors have recently reported cases successfully treated by laparoscopy. Westphalen — study design, data analysis, writing.

The patient was taken to theatre for a right sided exploration and hernia repair under general anaesthesia.

De Garengeot’s hernia – Wikipedia

An infraumbilical incision was made, and pneumoperitoneum was obtained by using Hasson’s open technique. On the other hand, the rate of recurrence was significantly lower in the mesh treated group [ 33 ]. In that case the diagnosis of De Garengeot hernia was determined preoperatively and the patient underwent open surgery via inguinotomy, however dissection of the appendix base presented technical difficulties and the surgeon opted for laparoscopy to solve that problem [11].

We then turned our attention to the right inguinal swelling. Open in a separate window. Cir Esp 95 3: Depending on protocol and reporting expertise, CT has demonstrated some value, with only 4 reported cases where CT has given the correct diagnosis [ 1719 — 21 ]. Oliveira — data collections, literature review. She was seen twice afterwards as an outpatient, once for removal of the drain and a second time for removal of staples.


After identification of the sac, the adjacent tissues were dissected, and the sac was opened. Appendiceal pus in a hernia sac simulating strangulated femoral hernia: The migration of the appendix into the hernia sac in an inguinal hernia is a rare event Amyand hernia and even rarer in incarcerated femoral hernias, which are called De Garengeot hernia [3].

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.

She was afebrile, normotensive, and denied abdominal pain, bloating, nausea or vomiting. This was reported as a right sided femoral hernia and the caecum and the ileocaecal junction were in close proximity to the hernial orifice.

De Garengeot’s hernia

EM is the chief surgeon of this case and the main author of this case report, APa helped him in this operation and, with VD, contributed in the collection and interpretation of data.

As the appendix was not inflamed, it was decided not to perform an appendectomy. We will be provided with an authorization token please note: J R Coll Surg Edinb ; Case Presentation 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. We were therefore able to promptly perform an appendectomy laparoscopically, eliminating the need for laparotomy and peritoneal contamination.


Abstract de Garengeot hernia is a rare subtype of a femoral hernia with incarceration of the appendix. Published online Jan The vermiform appendix is a blind ended tubular structure connected to the caecum.

Presentation of case An 86 years-old male patient, comes to Emergency Department complaining of painful bulging in the right inguinal region, associated with local inflammatory signs. Sources of funding No sources of funding. Diagnosis and operative management of a perforated de Garengeot hernia.

The skin was closed with reabsorbable poliglecaprone 25 suture and a pressure dressing applied. Six patients underwent preoperative ultrasound in addition to a CT 1317, 18, 21, 30, 32 and fifteen patients had a preoperative CT as the only imaging method 1, 5, 9, 10, 12, 14, 19, 20, 22, 24 — 26, 29, This article has been cited by other articles in PMC.

A year-old female was referred as an emergency by her General Practitioner with a two-week history of a painless irreducible lump in the right groin. Am J Emerg Med 32 5: An appendicectomy was then done and the base was buried using purse-string technique with absorbable polydioxanone suture.

CT scan of the abdomen showing the abscess-like collection white arrow in the right lower quadrant. Computerized tomography can help defining the preoperative diagnosis and surgical planning as well, but it does not change the surgical approach that is indicated to cases of incarcerated hernia.

Similar to our cases, most cases are done through a groin incision, using one of the femoral hernia repair approaches [ 2324 ]. Author information Article notes Copyright and License information Disclaimer.