Laparoscopic treatment of De Garengeot hernia with Progrip

Ann Ital Chir. 2020 Jun 16:9:S2239253X2003220X.

Abstract

Background: Many eponyms have been used to classify some rare conditions of incarceration of a hernia at the level of the groin and femoral canal. The incarceration of the appendix at the level of the groin canal was first described by Claudius Amyand, while the incarceration of the appendix inside the femoral canal is a condition known as De Garengeot hernia. The incidence of such an event is very low and surgical treatment is usually performed via inguinal approach.

Case presentation: We describe the case of a 63-year-old woman who presented upon arrival at the Emergency Room a sore tumefaction in the femoral region with skin erythema. The patient had never undergone surgery for groin or femoral hernias. After performing ultrasound reporting the presence of an incarcerated intestinal loop, the patient underwent surgery. Laparoscopic exploration highlighted the presence of a De Garengeot hernia. After exploration, it was decided to continue the laparoscopic operation: at first, the hernia sac was reduced, then a self-gripping mesh was put in place. Finally, after the closure of the peritoneum, the operation was completed by performing a laparoscopic appendectomy. The patient was discharged from hospital three days from surgery with an antibiotic therapy for further two days after discharge. After three months, upon clinical examination, no recurrences of hernia were evident.

Conclusions: We describe a rare case of De Garengeot hernia treated laparoscopically. The treatment of such a condition is not standardized because of the few cases described. The laparoscopic approach should always be considered to perform at least an exploration of the abdominal cavity and evaluate the contents of the hernia sac. Laparoscopic hernia treatment should be carried out by experienced surgeons who are familiar with the technique and apply it routinely.

Key words: Appendicitis, De Garengeot, Hernia, Laparoscopy.

Molti eponimi sono stati utilizzati per classificare alcune condizioni rare di incarceramento di un’ernia a livello del canale inguinale e femorale. L’incarceramento dell’appendice a livello del canale inguinale è stato descritto per la prima volta da Claudius Amyand mentre l’incarceramento dell’appendice all’interno del canale femorale è una condizione che conosciuta come ernia di de Garengeot. L’incidenza di tale evento è molto bassa e il trattamento chirurgico è solitamente eseguito per via inguinotomica.

Publication types

  • Case Reports

MeSH terms

  • Appendectomy
  • Appendicitis* / complications
  • Appendicitis* / diagnostic imaging
  • Appendicitis* / surgery
  • Appendix* / diagnostic imaging
  • Appendix* / surgery
  • Female
  • Hernia, Femoral* / complications
  • Hernia, Femoral* / diagnostic imaging
  • Hernia, Femoral* / surgery
  • Humans
  • Laparoscopy
  • Middle Aged
  • Surgical Mesh
  • Ultrasonography