Case report on diagnosis and management of complicated De Garengeot's hernia

De Garengeot's hernia is a rare condition where the appendix is located within a femoral hernia, first described by René-Jacques Croissant de Garengeot. It occurs in 0.5-1 % of femoral hernia cases, with an even rarer incidence of appendicitis within the hernia sac. Prompt diagnosis and management are essential, especially when complicated by appendicitis.

A 63-year-old female presented with a two-week history of a painful right groin lump. Physical examination showed an irreducible lump without signs of bowel obstruction or fever. Imaging suggested an incarcerated femoral hernia. Intraoperatively, an inflamed appendix and necrotic omentum were discovered within the hernia sac, prompting an appendectomy and hernia repair. The patient had an uneventful recovery.

De Garengeot's hernia is challenging to diagnose preoperatively, often mistaken for an incarcerated femoral hernia. The condition requires careful consideration of surgical approaches, including the use of mesh in uncontaminated fields, and the necessity of appendectomy. CT imaging can aid in diagnosis but is not always accurate. Early surgical intervention is crucial to prevent complications.

De Garengeot's hernia is a rare but serious condition requiring timely surgical intervention for favourable outcomes. Early diagnosis and appropriate management are vital in ensuring patient recovery and reducing recurrence risks.