Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2021; 9(36): 11355-11361
Published online Dec 26, 2021. doi: 10.12998/wjcc.v9.i36.11355
De Garengeot hernia with avascular necrosis of the appendix: A case report
Min-Quan Yao, Bing-Hong Yi, Yong Yang, Xiao-Qi Weng, Jin-Xing Fan, Yu-Peng Jiang
Min-Quan Yao, Bing-Hong Yi, Yong Yang, Xiao-Qi Weng, Jin-Xing Fan, Yu-Peng Jiang, Departments of Gastrointestinal Surgery, Tongxiang First People’s Hospital, Jiaxing 314500, Zhejiang Province, China
Author contributions: Yao MQ and Yi BH wrote the manuscript; Yang Y and Weng XQ collected the information and images; Jiang YP and Fan JX reviewed the manuscript; all authors were involved in drafting the manuscript and revising it critically for important intellectual content, read and approved the final manuscript and take public responsibility for appropriate portions of the content and have agreed to be accountable for all aspects of the work.
Supported by Zhejiang Provincial Medical Science Research Foundation, No. 2020ZH053 and No. 2021KY1133.
Informed consent statement: Informed consent was obtained from the patient for publication of this report.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Peng Jiang, BSc, Surgeon, Departments of Gastrointestinal Surgery, Tongxiang First People’s Hospital, No. 1918 Jiaochang East Road, Jiaxing 314500, Zhejiang Province, China. 13567321611@qq.com
Received: April 27, 2021
Peer-review started: April 27, 2021
First decision: June 5, 2021
Revised: June 6, 2021
Accepted: August 16, 2021
Article in press: August 16, 2021
Published online: December 26, 2021
Processing time: 240 Days and 11 Hours
Abstract
BACKGROUND

An incarcerated hernia is a common cause of acute abdominal pain. There are various types of incarcerated hernias, including incarcerated hernias of the appendix. These hernias are often complicated by appendiceal inflammation, necrosis, and suppuration, which affect the outcome of surgical repair. A De Garengeot hernia is a femoral hernia that contains the appendix. This type of hernia has a low incidence. When a De Garengeot hernia is clinically suspected, emergency surgical treatment should be performed as soon as possible.

CASE SUMMARY

A 59-year-old man was admitted to the hospital with a painful right inguinal mass that had suddenly developed 6 hours earlier. Physical examination revealed a 4 cm × 2 cm palpable mass in the right groin. The mass was hard and could not be reduced due to tenderness. It did not descend into the scrotum. B-ultrasound revealed an incarcerated hernia. During surgery, the hernia was found to contain the appendix, which exhibited distal avascular necrosis. A De Garengeot hernia was diagnosed according to the classification criteria of this type of inguinal hernia. Laparoscopic reduction of the incarcerated hernia, appendectomy, and small-incision femoral hernia repair were performed in the emergency department, and cefuroxime was administered as anti-infection therapy for 2 d postoperatively. After treatment, the patient had no abdominal pain or infection and was discharged on postoperative day 4. He had no recurrence of the inguinal hernia after 16 months of follow-up.

CONCLUSION

De Garengeot hernias have a low incidence and are difficult to diagnose. Laparoscopy is useful for their diagnosis and treatment.

Keywords: De Garengeot hernia; Incarcerated hernia; Avascular necrosis; Femoral hernia; Laparoscopy; Case report

Core Tip: Clinicians should be aware of the fact that a De Garengeot hernia has a low incidence and is difficult to diagnose in the early stages. When a De Garengeot hernia is clinically suspected, B-ultrasound or computed tomography and emergency surgical treatment should be performed as soon as possible. Laparoscopy is useful for the diagnosis and treatment of De Garengeot hernias and is thus worthy of clinical application.