De Garengeot hernias. Over a century of experience. A systematic review of the literature and presentation of two cases

Abstract

De Garengeot hernia is a rare femoral hernia that contains the vermiform appendix. It has always been a subject of interest, mainly because of its uncommon entity, but also because of the diagnostic challenge it presents and the lack of consensus in its surgical management. It mainly presents as an emergency, with strangulation of the femoral hernia and acute inflammation of the appendix. The purpose of this study is to present two cases of De Garengeot hernias, the different surgical approach in each one and to perform a systematic literature review on all published accounts of De Garengeot hernias focusing on the surgical management of the hernias that contained an inflamed appendix. A literature search was performed using the keywords ‘De Garengeot hernia’ and ‘appendicitis in femoral hernia’. All the published papers in the English language from 1898 to the end of 2019, as well as two patients from Lewisham and Greenwich NHS Trust, were included. There were 110 female vs 17 males. The majority of the described approaches were via either a Lockwood, or a transinguinal (Lothestein/McVay) incision. Most of the operations were done with an open incision. In the presence of an inflamed appendix, most hernias were repaired with sutures. Forty-one patients had their hernia repaired with non-absorbable sutures and four with absorbable. Most of the patients recovered without complications and were discharged after an average of 4.82 days.

Keywords:

• De Garengeot hernias
• femoral hernias
• acute appendicitis in a femoral hernia

Ethical approval

Ethical approval was not required or obtained for this study.

Informed consent

Verbal and written consent was given by both patients for publication of their case and use of CT and intraoperative images.

Disclosure statement

Each author in this paper declares no conflict of interest. No grants or financial support has been received for the completion of this study.

Data availability statement

The data that support the findings of this study are available from the corresponding author, [MC], upon reasonable request.