What does this research mean for the field?

Acute groin swelling in patients with inguinal hernia can indicate an appendicitis-related abscess with retroperitoneal extension outside the hernia sac, even in the absence of typical abdominal symptoms. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To report a rare case of a groin abscess secondary to perforated appendicitis in an elderly woman with an inguinal hernia.

June 18, 2026Open Access

Groin abscess outside the hernia sac secondary to perforated appendicitis in an older adult: a case report

Key Points

To report a rare case of a groin abscess secondary to perforated appendicitis in an elderly woman with an inguinal hernia.
Case report of an 84-year-old woman with a known inguinal hernia and advanced breast cancer.
Computed tomography was used to identify the abscess, followed by needle aspiration for confirmation.
Surgical intervention involved an appendectomy after the diagnosis of a perforated appendix.
The patient developed a groin abscess 4 days post-mastectomy, with initial conservative management providing only temporary relief.
A recurrent abscess near the cecum developed 31 days later, confirming the connection to the perforated appendix.
The patient fully recovered without recurrence at the three-month follow-up.

Abstract

Abstract Groin abscesses secondary to acute appendicitis are rare, particularly when inflammation spreads retroperitoneally and the abscess forms outside the hernia sac rather than within such as occurs in Amyand’s hernia. An 84-year-old woman with advanced breast cancer and a known inguinal hernia developed a progressively enlarging right groin mass 4 days after mastectomy. Computed tomography revealed a fluid collection, and needle aspiration confirmed an abscess. Conservative management led to temporary improvement; however, a recurrent abscess near the cecum appeared 31 days later. Surgical intervention revealed a partially perforated appendix, indicating retroperitoneal extension of appendiceal inflammation as the cause of the groin abscess, and appendectomy was performed. The patient recovered without recurrence at the three-month follow-up. Acute groin swelling in patients with inguinal hernia should prompt suspicion for appendicitis-related abscess, even without typical abdominal symptoms. Early imaging is essential, particularly in older adults with atypical presentations.

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