De Garengeot Hernia in a Male Patient: Case Report of an Incarcerated Appendix Managed by a Hybrid Approach

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INTRODUCTION: De Garengeot hernia is a rare condition in which the appendix is trapped within a femoral hernia. It accounts for less than 1% of femoral hernia cases and is more common in females, making its occurrence in males particularly unusual. Diagnosis is challenging because symptoms and laboratory findings are often nonspecific, and no standardized surgical protocol exists. CASE PRESENTATION: We report the case of a 69-year-old male who presented with a 4-day history of a tender, irreducible right groin lump. He was afebrile with stable vital signs and had unremarkable laboratory investigations. CT revealed the appendix within the right femoral hernia sac without signs of acute appendicitis. Laparoscopic exploration demonstrated the appendix tip within the femoral sac, with a bulky and gangrenous mesoappendix. A laparoscopic cecectomy was performed, followed by a low groin incision to reduce and excise the hernia sac. The femoral canal was narrowed with interrupted polypropylene sutures. The patient recovered uneventfully and was discharged the following day. CONCLUSIONS: This case highlights the diagnostic and therapeutic challenges of De Garengeot hernia and highlights the value of ongoing documentation to inform future surgical practice.

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