Mridha Md Shoieb Hossain, El-Shihaby Ayman, Arunachalam Lakshmanan
Dept. of General Surgery, Doncaster and Bassetlaw Teaching Hospitals, NHS Trust, Doncaster, UK.
Dept. of Colorectal Surgery, Doncaster and Bassetlaw Teaching Hospitals, NHS Trust, Doncaster, UK.
Int J Surg Case Rep. 2025 Sep;134:111767. doi: 10.1016/j.ijscr.2025.111767. Epub 2025 Aug 8.
Femoral hernia is more common in women than in men, with the content of hernia sac typically being omentum or small bowel. De-Garengeot's hernia is a rare surgical condition where appendix is found inside a femoral hernia. Its unusual presentation often leads to an intraoperative diagnosis.
We present the case of a 79-year-old woman who presented for an elective day case surgery for femoral hernia repair and intra-operatively, appendix was found inside the hernia sac. The patient underwent open femoral hernia repair, and the appendix was pushed inside along with the sac contents (as the appendix was not found inflamed). The patient made good post-operative recovery and was discharged on the same day.
De-Garengeot hernia should be suspected in any patients coming with groin swelling, particularly if there's a possibility of incarcerated femoral hernia. CT scan can help to diagnose the condition pre operatively, but it is mainly found during operation. Management is surgical and depends on intra-operative findings.
Despite being a rare case, a De-Garengeot hernia must be a differential diagnosis when evaluating a patient for a femoral hernia. Surgeons must be prepared for unexpected intraoperative findings.
股疝在女性中比男性更常见,疝囊内容物通常为大网膜或小肠。加朗热疝(De-Garengeot's hernia)是一种罕见的外科病症,即在股疝内发现阑尾。其不寻常的表现常导致术中诊断。
我们报告一例79岁女性患者,因择期日间手术进行股疝修补术,术中在疝囊内发现阑尾。患者接受了开放式股疝修补术,阑尾与囊内容物一起被推回(因阑尾未发现炎症)。患者术后恢复良好,当天出院。
对于任何出现腹股沟肿胀的患者,尤其是存在股疝嵌顿可能的患者,都应怀疑有加朗热疝。CT扫描有助于术前诊断该病,但主要还是在手术中发现。治疗方法为手术治疗,具体取决于术中发现。
尽管是罕见病例,但在评估股疝患者时,加朗热疝必须作为鉴别诊断之一。外科医生必须为术中意外发现做好准备。