# De Garengeot Hernia Presenting as a Rare Cause of Incarcerated Femoral Hernia

## TL;DR

A rare case of De Garengeot hernia, where the appendix is trapped in a groin hernia, is reported and highlights the importance of timely diagnosis and treatment.

## Contribution

This case report emphasizes the clinical significance of De Garengeot hernia and its management in elderly patients.

## Key findings

- De Garengeot hernia is often diagnosed intraoperatively due to nonspecific symptoms.
- Computed tomography can help identify the condition preoperatively by detecting a blind-ended tubular structure in the femoral canal.
- Prompt surgical intervention is crucial to avoid complications like perforation.

## Abstract

De Garengeot hernia is defined as the presence of the appendix within a femoral hernia sac and represents a rare surgical condition. Its clinical presentation closely resembles that of an incarcerated or strangulated femoral hernia, often leading to delayed or intraoperative diagnosis.

We report the case of an elderly woman who presented with acute right-groin pain and an irreducible groin mass concerning for an incarcerated femoral hernia. Emergent open exploration through an inguinal approach revealed a gangrenous appendix within the femoral canal. Appendectomy and primary tissue repair were performed, and the patient recovered uneventfully.

Due to nonspecific clinical findings, De Garengeot hernia is most frequently diagnosed intraoperatively. Computed tomography may assist in preoperative diagnosis when a blind-ended tubular structure contiguous with the cecum is identified within the femoral canal. Prompt surgical intervention is essential to prevent perforation and infectious complications. While laparoscopic repair may be considered in selected stable patients, open exploration remains the standard approach in emergency settings.

Maintaining a high index of suspicion for De Garengeot hernia in elderly women presenting with irreducible groin masses allows for timely diagnosis and definitive surgical management with excellent outcomes.