Sutharsan Ganeshamoorthy, Nirushala Santiago Anne, Gobishangar Sreekanthan
Surgery, Teaching Hospital, Jaffna, Sri Lanka.
Department of Surgery, Faculty of Medicine, University of Jaffna, Sri Lanka.
Int J Surg Case Rep. 2024 Dec;125:110641. doi: 10.1016/j.ijscr.2024.110641. Epub 2024 Nov 23.
De Garengeot's hernia is a rare condition where the appendix is located within a femoral hernia, first described by René-Jacques Croissant de Garengeot. It occurs in 0.5-1 % of femoral hernia cases, with an even rarer incidence of appendicitis within the hernia sac. Prompt diagnosis and management are essential, especially when complicated by appendicitis.
A 63-year-old female presented with a two-week history of a painful right groin lump. Physical examination showed an irreducible lump without signs of bowel obstruction or fever. Imaging suggested an incarcerated femoral hernia. Intraoperatively, an inflamed appendix and necrotic omentum were discovered within the hernia sac, prompting an appendectomy and hernia repair. The patient had an uneventful recovery.
De Garengeot's hernia is challenging to diagnose preoperatively, often mistaken for an incarcerated femoral hernia. The condition requires careful consideration of surgical approaches, including the use of mesh in uncontaminated fields, and the necessity of appendectomy. CT imaging can aid in diagnosis but is not always accurate. Early surgical intervention is crucial to prevent complications.
De Garengeot's hernia is a rare but serious condition requiring timely surgical intervention for favourable outcomes. Early diagnosis and appropriate management are vital in ensuring patient recovery and reducing recurrence risks.
加朗若疝是一种罕见病症，即阑尾位于股疝内，由勒内 - 雅克·克罗桑·德·加朗若首次描述。它在股疝病例中占0.5% - 1%，疝囊内合并阑尾炎的发生率更低。及时诊断和处理至关重要，尤其是在合并阑尾炎的情况下。
一名63岁女性，有右腹股沟疼痛性肿块两周病史。体格检查发现一个不能回纳的肿块，无肠梗阻迹象或发热。影像学检查提示为嵌顿性股疝。术中发现疝囊内有发炎的阑尾和坏死的大网膜，遂行阑尾切除术和疝修补术。患者恢复顺利。
加朗若疝术前诊断具有挑战性，常被误诊为嵌顿性股疝。这种情况需要仔细考虑手术方式，包括在未污染区域使用补片，以及阑尾切除术的必要性。CT成像有助于诊断，但并不总是准确的。早期手术干预对于预防并发症至关重要。
加朗若疝是一种罕见但严重的病症，需要及时进行手术干预以获得良好预后。早期诊断和恰当处理对于确保患者康复及降低复发风险至关重要。
