Femoral appendicitis: an unusual case

The presentation of acute appendicitis in a strangulated femoral hernia is rare. The authors describe what they believe is the first reported case of necrotizing fasciitis as a consequence of a gangrenous appendix in this situation. An 80-year-old woman presented with crepitant cellulitis of her right thigh with fever and leukocytosis, leading to a preoperative diagnosis of necrotizing fasciitis. Intraoperatively, an unsuspected gangrenous appendix was found in an incarcerated femoral hernia. A knowledge of the existence of this rare and serious condition will avoid delay in its recognition and management.