Images in Clinical Medicine from The New England Journal of Medicine — De Garengeot’s Hernia. De Garengeot hernias are femoral hernias that contain the appendix. It is a rare phenomenon, with only 1% of all femoral hernias containing the appendix (and. De Garengeot hernia should be suspected in an elderly woman presenting with signs and symptoms of a strangulated hernia. The differential.
|Published (Last):||18 August 2016|
|PDF File Size:||20.89 Mb|
|ePub File Size:||11.45 Mb|
|Price:||Free* [*Free Regsitration Required]|
To our knowledge, fewer than cases of de Garengeot hernia have been reported, and no standard surgical approach has been described for this condition.
De Garengeot’s hernia, although very rare, should be included in the differential diagnosis of cases with strangulated hernia and should receive the optimal treatment. Int J Surg Case Rep. The presentations of both of our cases are that of a typical groin hernia, with irreducible, tender lumps in the groin. This article has been cited by other articles garengeor PMC. Conclusion This paper presents a case report of a De Garengeot hernia patient who presented a good evolution after surgery.
National Center for Biotechnology InformationU. The postoperative course of the patient was uneventful, without any surgical site infection SSIand she was discharged on the postoperative Day 8.
She was afebrile, normotensive, and denied abdominal pain, bloating, nausea or vomiting. Postoperatively most patients recover without complications, with an average hospital stay of 5 days in the case reports we reviewed; this however depends on the state of the appendix during surgery, as perforated appendix is significantly more likely to lead to surgical site infection in the postoperative period.
Written informed consent was obtained from the patient for publication of this case reportand accompanying images. This case reports an elderly man with incarcerated hernia diagnosed with De Garengeot hernia intraoperatively and submitted to open inguinal hernia repair with mesh and appendectomy trough the inguinotomy at same surgical procedure. APr and TK are surgeons from another Hospital who helped in the collection of literature references and review analysis. Laparoscopic view of the femoral hernia with the incarcerated appendix.
Both patients were systemically well with no bowel symptoms; this is despite patient 1 having an obstructed and partially strangulated hernia. Westphalen — study design, data analysis, writing.
J Surg Case Rep 7: The appendix was resected and the femoral ring was approximated with sutures without use of a mesh. When facing a patient with incarcerated hernia, emergency surgery must be indicated. Diagnosis and operative management of a perforated de Garengeot hernia. In our patient, the unusual presentation of the hernia prompted us to do a diagnostic laparoscopy first, during which the appendix was seen entering the hernia sac.
In one case an open appendectomy was performed and in the other the appendix was left in situ; both had uneventful recovery. We hope that this case report adds to the growing literature on this condition, which will ultimately allow for more detailed case-control studies and systematic reviews in order to establish gold-standard diagnostic studies and optimal surgical management in future.
Operative Technique An infraumbilical incision was made, and pneumoperitoneum was obtained by using Hasson’s open technique. The differential diagnosis of a localized abscess of uncertain origin was also considered.
Acute suppurative appendicitis occurring within femoral hernia: Clinical significance of de Garengeot’s hernia: After identification of the sac, the adjacent tissues were dissected, and the sac was opened. CT diagnosis of acute appendicitis in a femoral hernia.
A record of sixteen personal cases. Indexed in Web of Science. The sac contained a healthy appendix which was easily reducible.
A review of the literature indicates the incidence of de Garengeot hernias to be greater in women, paralleling the sex-related incidence of femoral hernias. Appendiceal diverticulitis in hernai femoral hernia causing necrotizing fasciitis of the right inguinal region: Due to the infrequency of the case, there is no standard surgical practice, and cases are managed based on first principles.
Int J Surg Case Rep De Garengeot appendicitis – rare variant of a common medical condition.
She did not have any urinary or bowel symptoms. D Inflamed skeletonized appendix after ligation of the appendiceal artery. Indian J Surg 75 Suppl 1: Its incidence varies between 0. At the time of his arrival the patient herniw no significant abdominal pain during the last 48 h or any change in his bowel movements.
De Garengeot’s hernia
Note the oral contrast in the colon, past the ileocaecal junction. Case Reports in Surgery.
Several surgical tactics were used previously and considered acceptable, such as appendectomy followed by hernia correction in a second time, laparotomy for appendectomy and hernia correction by inguinotomy or even appendectomy through the hernia sac itself with correction of femoral hernia at the same garengeog time . Case Rep Gastroenterol 3 3: Discussion The presence of the appendix within a femoral hernia sac is uncommon and is generally found only during surgery.
de Garengeot hernia with appendicitis treated by two-way-approach surgery: a case report
Both had open femoral hernia repair, one with appendectomy and one with the appendix left in situ. There was an incidental finding of chronic sigmoid diverticular disease. The appendix was sent for histological analysis that showed no signs of appendicitis. National Center for Biotechnology InformationU. Clinical examination is of limited value in identifying the content of the femoral hernia.
Pathological examination demonstrated acute appendicitis with transmural necrosis and peri-appendicitis. No ascites or dilated bowels were observed. This anatomical phenomenon is thought to occur in as few as 0.