De Garengeot Hernia Managed with Two-stage Laparoscopic Appendectomy and Laparoscopic Hernia Repair—A Case Report—

Abstract

A 74-year-old woman visited our hospital complaining of a painful, irreducible bulge in the right groin area. Her abdomen was soft and flat, without signs of peritoneal irritation on palpation. Blood examination showed a white blood cell count of 8,900/μL and C-reactive protein of 13.22 mg/dL. Computed tomography (CT) revealed a right femoral hernia. Emergency laparoscopic surgery was performed with a diagnosis of incarcerated right femoral hernia. A perforated appendix with purulence in the hernia sac was detected, which was passing through the right femoral canal. The first surgery involved laparoscopic appendectomy and intraperitoneal drainage. After 4 months, the second surgery comprised of laparoscopic mesh repair using the transabdominal preperitoneal approach.

Femoral hernia with incarceration of the appendix is rare and is known as de Garengeot hernia. We successfully accomplished the two-stage surgery with laparoscopic appendectomy and laparoscopic hernia repair in order to manage the de Garengeot hernia. We will report this case with a literature review.