De Garengeot hernia—Use of a novel surgical approach and literature review

Mizumoto, Ryo; Hendahewa, Rasika; Premaratne, Gamini

doi:10.1016/j.ijscr.2015.12.033

Cited by 16 publications

(27 citation statements)

References 12 publications

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“…Imaging findings on abdominal CT include the presence of the appendix within the femoral sac and signs of inflammation in the femoral canal. Complications of untreated De Garengeot's hernia include necrosis of the hernia contents with perforation and sepsis or abscess formation, bowel obstruction, and necrotizing fasciitis . These complications highlight the perils of misdiagnosis leading to inappropriate or delayed management.…”

Section: Discussionmentioning

confidence: 99%

“…Several approaches have been reported with minimal postoperative complications and comparable results. Laparoscopic appendectomy and hernioplasty via anterior approach is recommended in some cases in order to prevent surgical site infection and mesh contamination . Simple suture hernioplasty instead of mesh repair is suggested by a number of authors for the same reason .…”

Section: Discussionmentioning

confidence: 99%

“…The infrainguinal approach was used in our case with no need for further exposure, because the cecum and appendix were easily visualized. If the base of the appendix is not safely accessed, peritoneal entry may be gained by creating a plane superficial to the external oblique, division of linea semilunaris, medial retraction of rectus muscle, and incision of transversalis fascia and peritoneum …”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic appendectomy and hernioplasty via anterior approach is recommended in some cases in order to prevent surgical site infection and mesh contamination. 5,8 Simple suture hernioplasty instead of mesh repair is suggested by a number of authors for the same reason. 5,9 In our case, we performed the appendectomy and the mesh hernioplasty through the same incision without any signs of surgical site contamination.…”

Section: Discussionmentioning

confidence: 99%

“…A diagnosis of De Garengeot's hernia was made, and the patient was transferred to the operating room. After administration of preoperative antibiotics (cefuroxime 1500 mg, metronidazole 500 mg), a small incision was made (approximately 4 cm) beneath the inguinal ligament under general anesthesia (Lockwood's infrainguinal approach) . The femoral sac was carefully dissected to the level of the femoral orifice.…”

Section: Case Reportmentioning

confidence: 99%

See 4 more Smart Citations

Α very rare case of De Garengeot’s hernia: Acute appendicitis within a femoral hernia

Filippou

Fanidou

Alvanos

et al. 2018

Clinical Case Reports

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Key Clinical MessageDe Garengeot's hernia is a rare clinical entity. Appropriate and acute diagnosis in emergency basis is challenging (usually misdiagnosed as incarcerated femoral hernia), and the surgical management varies from case to case. This report emphasizes the importance of including De Garengeot's hernia in the differential diagnosis of incarcerated groin hernias and the need to establish a well‐defined strategy regarding surgical management options.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

See 3 more Smart Citations

Α very rare case of De Garengeot’s hernia: Acute appendicitis within a femoral hernia

Filippou

Fanidou

Alvanos

et al. 2018

Clinical Case Reports

View full text Add to dashboard Cite

show abstract

Seltene Ursache einer schmerzhaften Schwellung der rechten Leiste

Anheier

Schultheis

2017

Chirurg

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Treatment of de Garengeot’s hernia: a meta-analysis

Linder

Månsson

2018

Hernia

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Purpose de Garengeot’s hernia is a rare entity in which the appendix is located within a femoral hernia and is almost invariably encountered incarcerated in an emergency setting with concomitant appendicitis. In the literature, there are mostly single-case reports. The purpose of the present study was to perform a review of the literature to study the incidence, pathogenesis, demographics, clinical presentation, laboratory and radiological investigations, differential diagnosis, delay in diagnosis and treatment, operative findings, surgical technique, histological findings, the postoperative course, use of antibiotics, and complications regarding de Garengeot’s hernia. Methods A literature search was performed through PubMed with the following search terms, single or in combination: Garengeot, femoral hernia, and appendicitis. Additional references were also found within the articles, and two patients from Uppsala University Hospital were added. Results Between 1981 and 2016, 70 publications were identified, and with the additional two patients, the present series comprised 90 patients There were 75 women (median age 73.0 years) and 15 men (median age 78.0 years). On examination, an inguinal mass was found in 87 patients (97%), which was painful and the cause of primary complaint in 67 patients (74%): the median duration of symptoms was 3 days. Radiological investigations or ultrasound were performed in 67 patients (74%); computed tomography was the most accurate with a positive diagnosis in 23/34 patients. Appendicitis was found in 76 patients, gangrenous in 23, and perforated in 9. The surgical approach was inguinal in 76 patients, including 15 with concomitant laparotomy. The preperitoneal route was chosen in six patients, and laparoscopy alone in four patients. A mesh/plug was used in 22 patients (7/22 normal appendix) and suture repair in 59 (4/59 normal appendix: p < 0.01). Complications were analysed in 79 patients and occurred in 11%. There was no mortality. Conclusions de Garengeot’s hernia is rare, being indistinguishable from an incarcerated femoral hernia in general. A delay in surgery should be avoided but if needed, computed tomography may be used for differential diagnosis. Although there is no standard treatment, mesh material does not appear advisable in the presence of a perforation, and it is beneficial for the surgeons to perform their routine method rather than a specific technique.

show abstract

De Garengeot hernia—Use of a novel surgical approach and literature review

Cited by 16 publications

References 12 publications

Α very rare case of De Garengeot’s hernia: Acute appendicitis within a femoral hernia

Α very rare case of De Garengeot’s hernia: Acute appendicitis within a femoral hernia

Seltene Ursache einer schmerzhaften Schwellung der rechten Leiste

Treatment of de Garengeot’s hernia: a meta-analysis

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