Treatment of De Garengeot’s hernia using De Oliveira’s technic: A case report and review of literature

INTRODUCTION: The French surgeon Rene Jacques Croissant de Garengeot first described the finding of the Appendix inside a femoral hernia sac in 1731. The De Garengeot’s hernia is a rare entity, comprehending only 0.5–5% of the femoral hernias. The pathogenesis of this entity is still controversial, and in the same way, there are different theories to explain the occurrence of appendicitis inside the De Garengeot’s hernia. There is no standard technique in the treatment of this entity. PRESENTATION OF CASE: W.P.S., 84, female, admited for medical assistance due to claims of edema and flogistic signs in the right inguinal region, noted four days prior. There was no abdominal pain, discomfort, or other symptoms. The physical examination showed hard edema and bulging on the right inguinal region, colaborating for the hipotesis of incarcerated hernia. Patient was then submitted to inguinotomy and the vermiform Appendix was discovered inside the femoral hernia without signs of appendicitis. The case was conducted using the De Oliveira’s technique to femoral hernia repair and Liechenstein for the inguinal hernia repair. DISCUSSION: The De Garengeot’s hernia is a rare entity, comprehending only 0.5–5% of the femoral hernias(2), it represents an unusual finding and is, in the majority of cases, diagnosed intraoperatively. It’s pathogenesis is yet matter of discution. There is no standard approach for this hernia, possibly by the few numbers and variability of presentation of cases described. CONCLUSION: This paper presents a case of a 84yo female with De Garengeot’s hernia that was submitted to a correction using the De Oliveira’s technic. A low cost technic with great results without use of polypropylene mesh.