de Garengeot hernia with a mucinous neoplasm of the appendix, two clinical rarities combine to yield a first for the literature

Description

A woman in her 70s presented for a scheduled CT scan for workup of an adnexal lesion. The adnexa were within normal limits; however, a blind-ending tubular structure was noted in the right femoral canal (figures 1 and 2). The diagnosis of a de Garengeot hernia was made. This is a rare type of hernia that occurs when the appendix descends to lie in the femoral canal. Femoral hernias comprise roughly 3% of all abdominal wall hernias, and de Garengeot hernias comprises 0.8%–1% of all femoral hernias.1

Figure 1

CT scan axial images. Green arrows: dilated appendix in the right femoral canal with prominent adjacent soft tissue stranding.

Figure 2

CT scan sagittal slice. Green arrow: normal proximal appendix transitioning into abnormal, dilated distal appendix on entering the femoral canal.

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