Clinical Practice and Cases in Emergency Medicine

Introduction : A De Garengeot hernia is defined as a femoral hernia that contains the vermiform appendix.  While femoral hernias carrying the appendix are uncommon, strangulation of the appendix in the hernial sac with concurrent acute appendicitis is an extremely rare and life-threatening condition often presenting with an atypical clinical picture.    

 Case Report:  A 51-year-old man presented to the emergency department with two weeks of persistent right inguinal pain after heavy lifting.  Imaging revealed suspicion for an Amyand’s hernia, an inguinal hernia containing a portion of the appendix.  However, intraoperative findings revealed a strangulated De Garengeot hernia with gangrenous appendicitis.   

Conclusion: De Garengeot hernias are femoral hernias containing the appendix which are diagnostically challenging and require urgent surgical evaluation and intervention given high risk for strangulation.