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. Images in Clinical Medicine from The New England Journal of Medicine — De Garengeot’s Hernia.

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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].

An incarcerated femoral hernia was diagnosed and he underwent emergency surgery. This phenomenon is thought to occur in 0. She was known previously to have a spontaneously reducible lump in the right groin suggestive of a hernia.

This anatomical phenomenon is thought garegeot occur in as few as 0. We were able to obtain a correct diagnosis and perform an appendectomy prior to making a groin incision. The patient made an uneventful recovery and went home after two days. Author information Article notes Copyright and License information Disclaimer.

De Garengeot Hernia

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. Laparoscopic appendectomy was initially performed, followed by hernioplasty via the anterior approach to prevent properitoneal contamination. Both had open femoral hernia repair, one with appendectomy and one with the appendix left in situ.

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A groin ultrasound scan showed an approximately 5.

Intra-operative identification of a De Garengeot hernia: To the best of our knowledge, this approach has never been described before. In both cases preoperative CT was utilised to reach the correct diagnosis.

Clinical examination is of limited value in identifying the content of the femoral hernia. CT scan of the abdomen showing the abscess-like collection white arrow in the right lower quadrant. This aided the identification of the appendix as hernial sac content.

De Garengeot hernia: Case report and review

In our patient, the unusual presentation of the hernia prompted us to do a diagnostic laparoscopy first, during which the appendix was seen entering the hernia sac. Risk factors include a long pelvic appendix, abnormal embryological bowel rotation, and a large mobile caecum. Rene Jacques Croissant De Garengeot, a French surgeon, was the first to describe the presence of the appendix inside a incarcerated femoral hernia in The rest of the wound was closed in layers, by using absorbable sutures for deep subcutaneous layer and staples for skin.

Spencer Netto — writing. 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 ]. Abstract de Garengeot hernia is a rare subtype of a femoral hernia with incarceration of the appendix.

Several surgical approaches exist, including open or laparoscopic approaches either with or without appendectomy, with mesh or simple suture hernioplasty. No ascites or dilated bowels were observed. Laparoscopic findings showing migration of the appendix into the femoral hernia. Report of two cases and review of the literature.


On admission, the patient was afebrile with age-appropriate vital signs. Therefore, selection of the appropriate surgical approach to prevent wound infection is important, especially in the presence of appendicitis.

Email alerts New issue alert. She had no known allergies. The rate of SSI for inguinal and femoral hernia repairs is 0. An infraumbilical incision was made, and pneumoperitoneum was obtained by using Hasson’s open technique. Wise L, Tanner N. As for the technique to be used, due to the rarity of this disease, it was not possible to establish a standard conduct yet.

De Garengeot’s hernia

Swallowing-related quality of life after free flap surgery due garegneot cancer of the herbia and neck. In Maingot R, editor. Dissection was carried down to the neck of the sac, which was then ligated, followed by excision of the sac. Wound complications were specially related to older patients with delayed diagnosis and treatment [2]. A major portion of the appendix was seen to pass through a defect adjacent to the inguinal ligament.

Although some authors have reported successful mesh repairs per infra-inguinal incision performed in the presence of appendicitis, we insist that the surgical site of hernioplasty should not be contaminated. View large Download slide. The swelling was irreducible but not strangulated.