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.
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In one case an open appendectomy was performed and in the other the appendix was left in situ; both had uneventful recovery. An incision was made externally over the right groin swelling and then carried down to the hernia sac, which appeared to be a femoral hernia.
De Garengeot Hernia
Int J Surg Case Rep 3 3: 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. The similarities in the reported cases may be of some informative value for clinicians. A year-old lady presented to the emergency room with a right groin mass that had appeared suddenly 4 days before and then gradually increased in size.
The patient evolved clinically well without postoperative complications or signs of recurrence four months after surgery. Cir Esp 95 3: Conflicts of interest No conflicts of interest. Our cases are the first ones where oral plus intravenous contrast was used for the CT scan, which helped to demonstrate the lack of small and large bowel involvement in the hernia.
APr and TK are surgeons from another Hospital who helped in the collection of literature references and review analysis. Conclusion This paper presents a case report of a De Garengeot hernia patient who presented a good evolution after surgery.
A blunt port was then inserted through the incision and a mm, degree scope was used to examine the gaeengeot cavity. Most case reports recommend that hernial defects should be repaired with nonabsorbable sutures.
Case Reports in Surgery
This phenomenon is thought to occur in 0. It has even been reported that, after the spontaneous reduction of a perforated appendix, the hernia neck seals off the infected collection, preventing peritoneal involvement [ 9 ]. This entity clinically presents as a nonspecific incarcerated hernia, with irreducible groin bulge, usually painful and associated gaeengeot inflammatory signs [7,8].
Hernioplasty was performed via the anterior approach to prevent properitoneal contamination. The rest of the wound was closed in layers, by using absorbable sutures for deep subcutaneous layer and staples for skin. Laparoscopic view of the femoral hernia with the incarcerated appendix.
But only inHevin performed the first appendectomy in an incarcerated femoral hernia . You can login by using one of your existing accounts. We were therefore able to promptly perform an appendectomy laparoscopically, eliminating the need for laparotomy and peritoneal contamination.
de Garengeot hernia with appendicitis treated by two-way-approach surgery: a case report
JD, male, 86 years, referred to hernnia emergency department of a reference service in General Surgery with complaints of painful bulging in the right inguinal region during the last four days.
Can J Heria ; The patient went home on day one after the operation. On admission, the patient was afebrile with age-appropriate vital signs.
In Maingot R, editor. The patient had an abdominal radiograph which was unremarkable. A computed tomographic CT scan of the abdomen and pelvis was obtained to help differentiate between intraabdominal and localized pathology and to plan our surgical approach.
He denied previous symptoms of hernia. Using a different approach for each surgery could help prevent contamination of the surgical site. A De Garengeot hernia masquerading as a strangulated femoral hernia. Author information Article notes Copyright and License information Disclaimer.
De Garengeot’s hernia
It is thought that the introduction of foreign material into a potentially contaminated surgical field could further increase the risk of infection [ 631 ]. The primary concern was for an incarcerated, recurrent inguinal hernia resulting in tissue necrosis and abscess formation.
Abstract de Garengeot hernia is a rare subtype of a femoral hernia with incarceration of the appendix. 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.
Acute appendicitis within a femoral hernia: Initially a right inguinal incision was performed. Due to the vestigial nature of the appendix, strangulation does not result in mechanical obstruction, although ileus can occasionally develop secondary to inflammation. This was gwrengeot as a right sided femoral hernia and the caecum and the ileocaecal junction were in close proximity to the hernial orifice.