Femoral hernia with vermiform appendix herniation: a case report and review of the literature

Abstract

Femoral hernias constitute 2–4% of all groin hernia repairs. Herniation of the vermiform appendix into the femoral hernia sac is rare. The majority of patients with appendix hernias are asymptomatic and diagnosis is made intraoperatively. We report about a case of a female patient presenting with an irreducible right-sided femoral hernia without symptoms.

De Garengeot and Amyand: two rare hernial encounters

“…It has been suggested that the Ventral Hernia Working Group grading platform and Centers for Disease Control and Prevention surgical wound classification system be used to individualize and guide patient treatment 7 . Whether to perform an appendicectomy is also unclear, but even if the appendix is macroscopically normal, microscopic inflammation and/or stenosis secondary to incarceration and inflammation within the hernia neck cannot be excluded 2 . This being a rare presentation, a randomized trial is not possible.…”

“…This being a rare presentation, a randomized trial is not possible. The literature suggests the use of mesh is a safe option in clean or clean‐contaminated fields (such as a normal or mildly inflamed appendix) for a patient with few risk factors for surgical site infections 2,3,7 …”

“…[1][2][3] As of 2020, only about 140 cases have been reported. 2 In contrast, an Amyand hernia, where the appendix is contained within an inguinal hernia is relatively more common however still represents less than 1% of all inguinal hernias. [4][5][6] Claudius Amyand, a French-born English surgeon, performed the first successful appendicectomy on an 11-year-old boy with a perforated appendix within an inguinal hernia.…”

“…Femoral hernias represent only about 3% of all hernias 1 and in less than 5% of these, the sac contains the appendix. 1,2 The eponymous name for this condition being a de Garengeot hernia, first described in 1731 by French surgeon René-Jacques Croissant de Garengeot. [1][2][3] As of 2020, only about 140 cases have been reported.…”

Femoral Hernia: Open and Laparoscopic Surgery Approaches

“…The ultrasonography, computed tomography and magnetic resonance imaging help in identifying doubtful cases [6,9]. It can help in preoperative diagnosis of complications like the presence of appendicitis within femoral hernial sac [2].…”