Acute appendicitis as a complication of Garengeot's hernia: Case report

Garengeot's hernia is a rare variant of femoral hernia in which the sac contains the vermiform appendix. Described by René-Jacques Croissant de Garengeot in the 18th century, it represents between 0.5% and 3% of femoral hernias, with appendicitis within the hernia being even more exceptional. It is more common in elderly women due to predisposing anatomical factors.

A 77-year-old female patient was admitted to the emergency department with sudden and severe right inguinal pain (VAS 9/10), consistent with an incarcerated femoral hernia. During the surgical approach, acute appendicitis was identified within the hernial sac. An appendectomy and anatomical repair of the defect were performed using the McVay technique. The use of prosthetic material was ruled out due to the risk of contamination.

Acute appendicitis in a Garengeot hernia is an exceptional clinical entity that is difficult to diagnose preoperatively and requires individualized management. The Guenther classification is a useful tool for standardizing the degree of appendiceal involvement and guiding the choice of surgical technique, especially in deciding whether to avoid using mesh in contaminated settings.