# Unexpected De Garengeot hernia in elective femoral hernia repair: A case report

## TL;DR

A rare case of De Garengeot hernia was found during a routine femoral hernia repair in an elderly woman.

## Contribution

This case report highlights the importance of considering De Garengeot hernia during femoral hernia surgery.

## Key findings

- De Garengeot hernia was incidentally found during an elective femoral hernia repair.
- The appendix was not inflamed and was reduced without appendectomy.
- Preoperative imaging may miss the diagnosis, and intraoperative findings are often definitive.

## Abstract

Femoral hernia is more common in women than in men, with the content of hernia sac typically being omentum or small bowel. De-Garengeot's hernia is a rare surgical condition where appendix is found inside a femoral hernia. Its unusual presentation often leads to an intraoperative diagnosis.

We present the case of a 79-year-old woman who presented for an elective day case surgery for femoral hernia repair and intra-operatively, appendix was found inside the hernia sac. The patient underwent open femoral hernia repair, and the appendix was pushed inside along with the sac contents (as the appendix was not found inflamed). The patient made good post-operative recovery and was discharged on the same day.

De-Garengeot hernia should be suspected in any patients coming with groin swelling, particularly if there's a possibility of incarcerated femoral hernia. CT scan can help to diagnose the condition pre operatively, but it is mainly found during operation. Management is surgical and depends on intra-operative findings.

Despite being a rare case, a De-Garengeot hernia must be a differential diagnosis when evaluating a patient for a femoral hernia. Surgeons must be prepared for unexpected intraoperative findings.

•De Garengeot hernia is a rare condition where the appendix is found within a femoral hernia sac.•It is usually diagnosed intraoperatively, as preoperative imaging like ultrasound may miss the diagnosis.•This case involved an incidental finding of a non-inflamed appendix during elective femoral hernia repair.•The appendix was reduced without appendectomy due to anatomical limitations and absence of inflammation.•Surgeons should maintain a high index of suspicion for De Garengeot hernia, even in asymptomatic patients.

De Garengeot hernia is a rare condition where the appendix is found within a femoral hernia sac.

It is usually diagnosed intraoperatively, as preoperative imaging like ultrasound may miss the diagnosis.

This case involved an incidental finding of a non-inflamed appendix during elective femoral hernia repair.

The appendix was reduced without appendectomy due to anatomical limitations and absence of inflammation.

Surgeons should maintain a high index of suspicion for De Garengeot hernia, even in asymptomatic patients.