Acute appendicitis within a femoral hernia (De Garengeot hernia): A case report

De Garengeot hernia is a rare form of femoral hernia in which the vermiform appendix is contained within the hernia sac. When the herniated appendix becomes inflamed, the clinical presentation may mimic an incarcerated or strangulated groin hernia, making preoperative diagnosis challenging. Computed tomography (CT) can facilitate accurate diagnosis by demonstrating the femoral location of the hernia and identifying the appendix within the hernia sac. We report an 84-year-old man who presented with a 4-day history of a painful, irreducible right groin swelling and vomiting, initially suspected clinically to represent an incarcerated right inguinal hernia. Contrast-enhanced CT demonstrated a right femoral hernia containing an inflamed appendix continuous with the cecum, enabling a preoperative diagnosis of De Garengeot hernia with acute appendicitis. The patient underwent appendicectomy and primary suture repair of the femoral hernia, with histopathological confirmation of acute appendicitis and serositis. This case highlights the importance of careful CT assessment of an irreducible groin mass. Recognition of the femoral location of the hernia and demonstration of continuity of its tubular content with the cecum are key imaging features that can facilitate accurate preoperative diagnosis and inform surgical management.