A first of its kind: iliacus hernia containing an inflamed appendix.

Iliacus hernias are extremely rare internal hernias with only sporadic reports in the literature. No previous report has documented an inflamed appendix herniating into the iliacus muscle. This report describes such a case, highlighting the diagnostic challenges and the surgical management of this atypical hernia. This case expands the spectrum of internal hernias and emphasizes the importance of advanced imaging and a customized surgical approach when encountering atypical hernia locations. Early recognition and prompt management are critical for this rare hernia type. Further study is needed to establish standardized treatment protocols for internal hernias in uncommon locations.