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. Images in Clinical Medicine from The New England Journal of Medicine — De Garengeot’s Hernia.
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For commercial re-use, please contact journals. Physical evaluation—groin bulge with inflammatory signs. To receive news and publication updates for Case Reports in Surgery, enter your email address in the box below.
A mobile caecum, large caecum or visceroptosis is also considered a risk factor for de Garengeot hernia [ 14 ]. We present a case of a patient with de Garengeot hernia with appendicitis who was successfully treated by performing a hybrid surgery, laparoscopic appendectomy, and anterior hernioplasty. However, there have been cases where the hernial sac and the appendix are reduced into the peritoneal cavity via midline laparotomy.
His previous medical history includes hypertension and smoking. Patient reported that four days before going to the hospital, after major physical effort evolved with an irreducible bulging in right inguinal region. We were also able to anticipate the contents of the hernia before opening the sac. Swallowing-related quality of life after free flap surgery due to cancer of the head and neck.
The similarities in the reported cases may be of some informative value for clinicians.
Case Reports in Surgery
Open in a separate window. No ascites or dilated bowels were observed. Discussion De Garengeot hernia is a rare entity that requires early treatment in order to avoid possible complications.
Risk factors include a long pelvic appendix, abnormal embryological bowel rotation, and a large mobile caecum. We therefore recommend initial diagnostic laparoscopy in the treatment of groin hernias with atypical agrengeot and when the contents of the hernia cannot be determined either clinically or radiologically.
De Garengeot Hernia
Westphalen — study design, data analysis, writing. However, hwrnia type of hernia has a garenteot risk for SSI, compared with the risk involved in usual hernioplasty. On admission, the patient was afebrile with age-appropriate vital signs.
Spencer Netto — writing. Open in a separate window. ThomasMD, M. 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 surgical time .
This phenomenon is thought to occur in 0. De Garengeot hernia is a rare condition in which appendicitis occurs within a femoral hernia. However, as demonstrated in patient 2, appendix which is visually confirmed healthy could be reduced and left in situ without compromising the postoperative outcome, whereas resection of a healthy appendix can lead to unnecessary infection risks [ 29 ].
Two days later, it evolved with progressive pain associated with local erythema.
De Garengeot’s hernia – Wikipedia
This type of hernia usually presents with therapeutic dilemmas, especially because of the risk of surgical site infection SSI. An 86 years-old male patient, comes to Emergency Department complaining of painful bulging in the right inguinal region, associated with local inflammatory signs.
Wound complications were specially related to older patients with delayed diagnosis and treatment . Dissection was carried down to the neck of the sac, which was then ligated, followed by excision of the sac.
A rare case of acute abdomen: Close mobile search navigation Article navigation. Her past medical history was significant for hypertension, gastroesophageal reflux disease GERDand right inguinal hernia repair 30 years before.
At six-month follow-up patient did not have any postoperative complications.
Laparoscopic findings showing migration of the appendix into the femoral hernia. Rene Jacques Croissant De Garengeot, a French surgeon, was the first to describe the presence of the appendix inside a incarcerated femoral hernia in These patients seldom develop signs of peritonitis, as the inflamed appendix is isolated from the peritoneal cavity by the tight neck of the hernia sac.
It is a rare condition that presents with a swelling mass in the groin, which is often tender. Patients may present fever, signs and symptoms that suggest obstructive acute abdomen and laboratorial exams may show non-specific results .
The resected specimen was sent off for histological analysis, which did not show any evidence of appendicitis. Intra-operative identification of a De Garengeot hernia: Initial diagnostic laparoscopy can be an invaluable adjunct in both diagnosis and treatment of atypical hernias. Surgeons performed hfrnia and inguinal repair of the femoral hernia with placement of a polypropylene mesh. The patient evolved clinically well without postoperative complications or signs of recurrence four months after surgery.
Due to the vestigial nature of bernia appendix, strangulation does not result in mechanical obstruction, although ileus can occasionally develop secondary to inflammation. As for the technique to be used, due to the rarity of this disease, it was not possible to establish a standard conduct yet. Moreover, the rates of SSI are 6.
Int J Surg Case Rep. Support Center Support Center. A tubular structure was seen in the hernial sac which did not take up the oral contrast; this was reported as an appendix in a femoral hernia. Note the oral contrast in the colon, past the ileocaecal junction. Then, two additional 5-mm trocars garengdot inserted in the left lower and middle abdominal regions.
In Maingot R, editor. The hernia could be reduced by deliberately pulling the appendix.