De Garengeot Hernia: A Rare Presentation of Femoral Hernia

Abstract De Garengeot hernia is an uncommon variant of femoral hernia in which the appendix lies within the hernia sac and is frequently overlooked before surgery. A 52-year-old woman presented with lower abdominal pain and vomiting, with a history of similar episodes that had settled spontaneously. Initial ultrasonography was inconclusive and she was managed as a suspected case of acute appendicitis. On re-examination, a small, tender swelling was detected in the right groin. Contrast-enhanced computed tomography subsequently demonstrated the appendix herniating through the femoral canal. The patient underwent appendicectomy and femoral hernia repair through a combined abdominal and infrainguinal approach with mesh placement. Post-operative recovery was uncomplicated. This case underscores the value of repeated clinical examination and targeted imaging in patients with atypical abdominal pain. Timely surgery, tailored to intraoperative findings, can lead to excellent clinical recovery.