2026 Volume 46 Issue 5 Pages 636-639
An 89-year-old woman presented to our gastroenterology department with epigastric pain and loss of appetite of three days’ duration. A painful mass was discovered in the right inguinal region, and computed tomography imaging showed an incarcerated right femoral hernia with bowel obstruction. Manual reduction was unsuccessful, and we performed emergency surgery the same day. Intraoperative exploration revealed a hernia sac incarcerated within the femoral ring, and part of the small intestine wall found to be incarcerated within the sac. After manually releasing the intestine, we partially resected the small intestine and performed a small-intestinal anastomosis. While exploring deeper into the site in an attempt to achieve complete resection of the hernia sac, the appendix was also found to be incarcerated. An appendectomy was performed, and, finally, we repaired the hernia completely by the McVay technique. Cases of Richter-type incarcerated femoral hernia together with de Garengeot hernia are extremely rare, and the possibility of multiple organs being incarcerated within the hernia sac should be kept in mind.
