De Garengeot hernia doubly complicated: A case report

Abstract

Introduction A strangulated De Garengeot's hernia with appendicitis is an extremely rare surgical presentation. Therefore, the diagnosis is challenging, and there are no recommendations regarding a specific surgical approach. Presentation of case We present the case of a 56-year-old woman with a De Garengeot's hernia doubly complicated: strangulated and with appendicitis in the hernia sac. The diagnosis was made intraoperatively, and it was managed fully through a single inguinal incision. No postoperative complication was presented, and the patient was discharged 48 h after. Discussion The clinical presentation of this sub-type of hernia is non-specific. Precise knowledge of the hernia sac content preoperatively is not mandatory, and it should not delay prompt emergency surgery. As long as there are no local signs of complicated appendicitis, a single inguinal incision may be sufficient to perform appendectomy and hernia repair. In the event of complicated appendicitis, an exploratory of the abdominal cavity is mandatory, and hybrid approaches are recommended. For an experienced surgeon, the laparoscopic approach (TAPP), including the treatment of the two pathologies and the exploration of the peritoneal cavity, represents the surgical technique of choice. Conclusion De Garengeot's strangulated hernia with appendicitis is an exceedingly rare double surgical emergency. When uncomplicated appendicitis, a single inguinal incision is sufficient to treat both appendicitis and abdominal wall defect. Hernia reduction, which young surgeons in the emergency room commonly attempt, should be abolished.

De Garengeot hernia in an elderly female: a case report

“…21,22 In cases of peritonitis, some authors claims that a midline approach would be the best option in order to exclude intra-abdominal extension of the septic process. 23 On what concerns about the appendix-preserving elective herniorrhaphy/hernioplasty, according to some studies, it seems to be an acceptable procedure if pre-operative imaging and intraoperative findings do not suggest acute appendicitis or circulatory compromise in the appendix. 9,17,24…”

Complicated Garengeot’s Hernia Associated with an Adnexal Tumor in a High-Rise Hospital

“…Currently, there are very few reports on Garengeot's hernia, given its infrequent occurrence, making its detection challenging, especially when associated with appendicular involvement. In cases where there is no inflammatory compromise of the appendix, the preferred treatment involves repair, either through open surgery or laparoscopic technique (TAPP), contingent upon an experienced surgeon capable of addressing both the appendicular condition and the hernia [14].…”