De Garengeot hernia with acute appendicitis

Aim. The presence of the appendix within a femoral hernia sac is a rare condition known as De Garengeot hernia. We report a case of De Garengeot hernia with concomitant appendicitis and a brief review of the literature on the pathogenesis, diagnosis and treatment of this uncommon condition. Case report. A 33 year-old woman was admitted to our Surgical Unit with acute-onset pain and swelling in the right groin region. Clinical signs and ultrasound imaging suggested the presence of a strangulated femoral hernia and the patient was operated on in emergency setting. An inflamed appendix was discovered within the hernia sac. Appendectomy via McBurney incision and prosthetic repair of the femoral ring were performed. The postoperative course was uneventful and at the 2 week and 1 year follow-up no signs of wound infection and no hernia recurrence were found. Conclusion. Since clinical signs are non-specific and radiological findings may often be misinterpreted, appendicitis within a femoral hernia sac is often an incidental finding during an emergency operation for strangulated femoral hernia. Appendectomy-associated hernia repair may be performed with or without prosthesis depending on the extent of surgical field contamination.

Just Another Pelvic Mass?

Objectives: To describe the case of a patient presenting with weight loss and a pelvic mass. Materials and methods: We performed an advanced search in MEDLINE using the key words "wasting syndrome", "actinomycosis" and "pelvic mass". Results: A 63-year-old woman had a well-delimited and tender pelvic mass and was found to be anaemic. Before scans were performed, clinicians considered malignancy and other diagnoses. Conclusion: Actinomycosis is a chronic infection that usually affects the abdomen. Because of the lack of specificity of clinical and radiological findings, a multidisciplinary approach is the keypoint for making an accurate diagnosis.