De Garengeot hernia with perforated appendicitis and a groin subcutaneous abscess: A case report

Int J Surg Case Rep. 2017:33:8-11. doi: 10.1016/j.ijscr.2017.02.028. Epub 2017 Feb 20.

Abstract

Introduction: De Garengeot hernia is rare. Although previous reports have suggested various surgical options according to patient condition, comorbidities, surgeon preference, and clinical findings during surgery, a treatment strategy has not been established.

Presentation of case: An 81-year-old woman presented with an irreducible tender mass that was subsequently diagnosed as an incarcerated femoral hernia with a subcutaneous abscess in the right groin. Intraoperative findings revealed a necrotic and perforated appendix strangulated by the femoral ring for which an appendectomy and herniorrhaphy was performed concurrently through the hernia sac. The subcutaneous abscess cavity was washed thoroughly and a drainage tube was placed within it. The patient recovered uneventfully.

Discussion: We suggest that the approach through the inguinal incision in both appendectomy and herniorrhaphy with drainage may be useful in avoiding intra-abdominal contamination in cases of de Garengeot hernia with subcutaneous abscess.

Conclusion: Here, we described a case of de Garengeot hernia with a subcutaneous abscess in the groin. Clinicians should consider de Garengeot hernia in patients with a groin hernia, make an early diagnosis, and promptly provide surgical treatment to reduce the risk of complications.

Keywords: Acute appendicitis; Appendectomy; De Garengeot hernia; Femoral hernia; McVay’s technique; Subcutaneous abscess.