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Atypical presentation of a de Garengeot Hernia: A Case Report

Introduction: An inflamed appendix found within a femoral hernia, a de Garengeot hernia, is a rare occurrence which can present with a variety of different symptoms and be a challenge to surgical management. Case Presentation: We present the case of a 59-year-old female who presented with migratory right lower quadrant pain and was found to have a de Garengeot hernia diagnosed pre-operatively on CT imaging. She was taken to the OR for an urgent laparoscopic appendectomy with closure of the femoral hernia sack. Given this is not a true repair, the patient was scheduled for an elective femoral hernia repair subsequently. Discussion: This is the first report of a de Garengeot hernia from the Toronto area. Our case is the first of its kind to present with typical signs of appendicitis without any obvious bulge in the groin. Conclusion: This case report describes two very common acute surgical presentations, appendicitis and incarcerated hernia, seen simultaneously with only one rare pathology.