988 De Garengeot's Hernia: Acute Appendicitis Within a Femoral Hernia - Diagnostic Challenges and Management.
Ahmed, Z S Azam, S Shenton, A Akingboye, A A
Ahmed, Z S
Azam, S
Shenton, A
Akingboye, A A
Affiliation
Crosshouse University Hospital NHS; The Dudley Group NHS Foundation Trust
Other Contributors
Publication date
2025/06/10
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Abstract
De Garengeot's hernia(DGH), a rare clinical entity, involves the presence of the appendix within a femoral hernia sac. It accounts for only 0.08-0.1% of all femoral hernias and is challenging to diagnose preoperatively. We present the case of an 87-year-old female with a 3-day history of right lower abdominal pain, nausea, and vomiting. Examination revealed a tender irreducible right groin lump with overlying erythema. Laboratory findings showed elevated inflammatory markers. A CT scan indicated a groin hernia with a tubular structure inside, although the nature of the hernia (inguinal or femoral) remained unclear. Emergency exploration confirmed a femoral hernia containing a necrotic appendix. A standard appendectomy and suture repair of the hernia were performed with uneventful recovered. The patient was followed up at 18 months and had no recurrence. DGH is a rare condition involving the appendix within a femoral hernia sac, accounting for only 0.08-0.1% of femoral hernias. * Diagnosis is challenging due to nonspecific symptoms, especially in elderly patients, requiring a high index of suspicion. * CT imaging, with 98% sensitivity and specificity, is essential for preoperative planning and differentiating it from other groin pathologies. * Definitive treatment involves appendectomy and hernia repair, with mesh use avoided in infected cases of potential infection risk. * Multidisciplinary discussions between surgeons and radiologists optimize decision-making and outcomes. * Awareness is critical as the aging population grows, highlighting the need for timely diagnosis and management of acute groin swellings. * Proper management leads to favorable outcomes; evidenced by the 16-month asymptomatic follow-up here.
Citation
Z S Ahmed, S Azam, A Shenton, A A Akingboye, 988 De Garengeot�s Hernia: Acute Appendicitis Within a Femoral Hernia � Diagnostic Challenges and Management,�BJS, Volume 112, Issue Supplement_10, June 2025, znaf128.148,�https://doi.org/10.1093/bjs/znaf128.148Top of Form