De Garengeot's hernia

Case contributed by Dr Piyush P Siwach

Presentation

Painful lump in right groin.

Patient Data

Age: 85 years
Gender: Female
CT

Right femoral hernia containing appendix and mesoappendix. Herniated appendix is inflamed, with surrounding fat stranding and free fluid in hernial sac.

Unrelated incidental findings include: distended gallbladder with calculi, left renal ngiomyolipoma and left pelvic varices with dilated left ovarian vein suggesting ovarian vein incompetence.

Case Discussion

This case demonstrates a unique pathology, with a combination of findings required to qualify for the fancy eponym: A femoral hernia containing an inflamed appendix. Surprisingly, this lady presented with relatively mild symptoms despite the impressive radiological appearance. She underwent urgent surgery which was uneventful.

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