A Case of Laparoscopic Repair of a Femoral Hernia with Incarceration of the Appendix

Saito, Takahiro; Otani, Satoshi; Sato, Yoshihiro; Tsuchiya, Takao; Ito, Fumio; Miura, Junichi

doi:10.3919/jjsa.75.2606

Cited by 5 publications

(4 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although some advocate removing the appendix in all cases, whether an appendectomy is mandatory in an otherwise non-inflamed appendix is under question. In this series, twenty-five patients (86.2%) suffered an appendectomy, but in three of them (12%), no signs of true appendicitis were present in the final histologic study [ 7 , 10 , 17 ]. In five other patients [4, 22, 27, 29, and our second unpublished case], an appendix-preserving procedure could be guaranteed without further complications.…”

Section: Discussionmentioning

confidence: 99%

“…A mesh repair of the femoral hernia defect was possible in all but four patients [ 9 , 10 , 15 , 18 ]. In these contaminated scenarios, the overall low mesh infection rate can likely be attributed to the parietal peritoneum acting as a natural barrier.…”

Section: Discussionmentioning

confidence: 99%

“…Still, in 4 cases, an appendix-sparing hernioplasty could be satisfactorily done, as the appendix was normal after the resolution of the hernia sac, always during TAPP procedures. In all but five patients [ 9 , 10 , 15 , 18 , 21 ], a prosthetic mesh could be used for the hernia repair. A polypropylene mesh was used most of the time.…”

Section: Diagnosismentioning

confidence: 99%

See 2 more Smart Citations

De Garengeot’s hernia patients entirely treated laparoscopically: a safe and feasible alternative—a systematic review

Gómez-Portilla

Merino

Heredia

et al. 2023

Langenbecks Arch Surg

View full text Add to dashboard Cite

Purpose Less than 450 cases of femoral hernias containing the vermiform appendix have been published since De Garengeot’s first description. A laparoscopic treatment option opened 15 years ago seems reliable and safe. A literature review of all the patients who have benefited from this new therapeutic alternative is presented. Methods A systematic review using the German Society of Surgery’s recommendations was performed for De Garengeot’s hernias totally treated laparoscopically. Keywords searched included “De Garengeot hernia” OR “femoral hernia appendix” OR “crural hernia appendix.” Results Only 29 out of 225 De Garengeot hernia’s manuscripts were identified describing patients entirely treated laparoscopically: 25 patients by a transabdominal preperitoneal hernia repair (TAPP) and 4 patients by a total extraperitoneal (TEP) procedure; 85.1% were females. The mean age was 71 years. Twenty-two patients had pre-operative imaging tests, sonography (2), computed tomography (14), or both (6). Nevertheless, only 56% had a preoperative diagnosis. Twenty-one cases required urgent treatment, while programmed surgery was possible in 7 instances. An appendix-sparing procedure could be done in 16% of the TAPPs. No postoperative complications occurred. The median hospital stay was 2.5 days. Conclusions The best surgical approach for a De Garengeot’s hernia is not defined, and many critical questions remain unanswered. A better understanding of the diagnosis and treatment of this peculiar hernia will supply guidelines for clinicians who may encounter it hereafter. A fully laparoscopic approach seems perfectly safe and feasible for this entity, and it could be considered the first-line alternative if enough expertise is available.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

De Garengeot’s hernia patients entirely treated laparoscopically: a safe and feasible alternative—a systematic review

Gómez-Portilla

Merino

Heredia

et al. 2023

Langenbecks Arch Surg

View full text Add to dashboard Cite

show abstract

“…Increased WBC and CRP levels could be markers to estimate the severity of appendiceal inflammation and/or abscess formation. Correct preoperative diagnosis was made in 47% of the patients by CT and/or ultrasonography (US) [13,17,20,24,26,29,30,32,33,[37][38][39][40][41][42][43][44][45][46]. Emergency surgery was performed in 88% of the patients.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological characteristics of De Garengeot hernia: six case reports and literature review

et al. 2021

View full text Add to dashboard Cite

Background De Garengeot hernia, wherein the appendix is present within a femoral hernia, is a rare disease; therefore, the clinicopathological features remain to be clarified. This study aimed to reveal the clinicopathological characteristics of De Garengeot hernia. Case presentation Six patients who underwent appendectomy and herniorrhaphy between 1999 and 2018 were included. The incidence of De Garengeot hernia was 3.2% among the 182 femoral hernias that required surgery during the study period. The median age of the patients was 78 years, and five patients were women. The median body mass index was 20.1. Patients frequently had fever or elevated CRP level. Preoperative diagnoses based on computed tomography were femoral (n = 3), inguinal (n = 2), and De Garengeot (n = 1) hernias. Emergency and elective surgeries were performed in four and two patients, respectively. Histopathological examination of the resected appendix showed gangrenous appendicitis (n = 3), perforated appendicitis (n = 2), and appendiceal ischemia (n = 1) in the patients. Postoperatively, one patient developed sepsis. Conclusions Preoperative diagnosis of De Garengeot hernia is often difficult, and patients frequently have severe appendicitis. Precise diagnosis is required, and emergency surgery should be considered depending on the severity of appendicitis.

show abstract

The uncommon preoperative diagnosis of a De Garengeot hernia and its more novel laparoscopic treatment

Sylvester,

Singh,

Haque

2024

BMJ Case Rep

View full text Add to dashboard Cite

This case report involves an elderly woman who presented with a 3-day history of a tender groin swelling on her right side. Her admission bloods were fairly unremarkable, but a preoperative ultrasound impressively confirmed a femoral hernia containing the appendix (De Garengeot hernia) and she underwent emergency laparoscopic hernioplasty with a prosthetic mesh and appendicectomy. The procedure found an incarcerated hernia with a strangulated tip of the appendix that unexpectedly separated upon gentle manipulation and histopathology revealed appendiceal inflammation. There were no complications with the patient’s recovery and she was discharged 2 days after surgery.

show abstract

A Case of Laparoscopic Repair of a Femoral Hernia with Incarceration of the Appendix

Cited by 5 publications

References 6 publications

De Garengeot’s hernia patients entirely treated laparoscopically: a safe and feasible alternative—a systematic review

De Garengeot’s hernia patients entirely treated laparoscopically: a safe and feasible alternative—a systematic review

Clinicopathological characteristics of De Garengeot hernia: six case reports and literature review

The uncommon preoperative diagnosis of a De Garengeot hernia and its more novel laparoscopic treatment

Contact Info

Product

Resources

About