De Garengeot's hernia

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De Garengeot's hernia is a rare subtype of an incarcerated femoral hernia. This eponym may be used to describe the incarceration of the vermiform appendix within a femoral hernia. [1] This mechanism is contrasted with the Amyand hernia, in which the appendix protrudes through an inguinal hernia.

Contents

Akopian and Alexander, named this hernia after the 18th century Parisian surgeon Rene Jacques Croissant de Garengeot. He is quoted in the surgical literature as the first to describe this hernia in 1731. Although the surgeon's full last name is Croissant de Garengeot, for linguistic convenience it has been suggested to abbreviate this eponym to "de Garengeot". De Garengeot's first-described patient developed tenderness and a bulge in her right upper thigh after lifting 24 lb of bread. The bulge was unable to be reduced, after which surgery was conducted and a femoral hernia was discovered. The hernia was reduced back into the peritoneal cavity and the patient made an adequate recovery in 6 weeks. [2] [3]

Similar as with the situation of an Amyand's hernia, the true nature of the incarcerated tissue is rarely diagnosed preoperatively. Patients present clinically similar to other incarcerated femoral herniae. Treatment consists of an appendectomy and hernia repair. Laparoscopic options are described. [4]

Epidemiology

De Garengeot hernia are most commonly seen in females and patients between 60 and 90 years of age. [5]

Diagnosis

Diagnosis of De Garengeot hernia is most commonly made at the time of surgery, but some are diagnosed pre-operatively by CT scan, ultrasound, or MRI. If De Garengeot hernia is suspected based on general clinical signs of abdominal tenderness or bulging, CT scan is recommended. [6]

Treatment

A individualized treatment approach is required based on the severity of the hernia and the surgeon's skill level and experience. Since the condition is rare, there have not been documented randomized control trials. De Garengeot hernias can be treated with closed reduction, laparoscopic repair, appendectomy, and open repair. [4] Mesh placement can be considered based on severity of the hernia. The most common route of surgical management was through a groin incision, and appendectomy was performed in 98.5% of patients. [5]

Prevention

Prevention of De Garengeot hernia involves measures that prevent hernias generally, such as maintaining a healthy weight, avoiding tight-fitting clothes, avoiding heavy straining when using the restroom, and avoiding improper heavy lifting.


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<span class="mw-page-title-main">Laparoscopy</span> Minimally invasive operations within the abdominal or pelvic cavities

Laparoscopy is an operation performed in the abdomen or pelvis using small incisions with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.

<span class="mw-page-title-main">Hernia</span> Abnormal exit of tissues or organs from the cavity they usually reside in

A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. The term is also used for the normal development of the intestinal tract, referring to the retraction of the intestine from the extra-embryonal navel coelom into the abdomen in the healthy embryo at about 7½ weeks.

<span class="mw-page-title-main">Appendectomy</span> Surgical removal of the vermiform appendix

An appendectomy or appendicectomy is a surgical operation in which the vermiform appendix is removed. Appendectomy is normally performed as an urgent or emergency procedure to treat complicated acute appendicitis.

<span class="mw-page-title-main">Hiatal hernia</span> Type of hernia

A hiatal hernia or hiatus hernia is a type of hernia in which abdominal organs slip through the diaphragm into the middle compartment of the chest. This may result in gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) with symptoms such as a taste of acid in the back of the mouth or heartburn. Other symptoms may include trouble swallowing and chest pains. Complications may include iron deficiency anemia, volvulus, or bowel obstruction.

<span class="mw-page-title-main">Nissen fundoplication</span> Surgical procedure to treat gastric reflux and hiatal hernia

A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. In GERD, it is usually performed when medical therapy has failed; but, with a Type II (paraesophageal) hiatus hernia, it is the first-line procedure. The Nissen fundoplication is total (360°), but partial fundoplications known as Thal, Belsey, Dor, Lind, and Toupet fundoplications are alternative procedures with somewhat different indications and outcomes.

<span class="mw-page-title-main">Inguinal hernia</span> Medical condition in which contents of the abdominal cavity protrude through the inguinal canal

An inguinal hernia or groin hernia is a hernia (protrusion) of abdominal cavity contents through the inguinal canal. Symptoms, which may include pain or discomfort especially with or following coughing, exercise, or bowel movements, are absent in about a third of patients. Symptoms often get worse throughout the day and improve when lying down. A bulging area may occur that becomes larger when bearing down. Inguinal hernias occur more often on the right than left side. The main concern is strangulation, where the blood supply to part of the intestine is blocked. This usually produces severe pain and tenderness of the area.

<span class="mw-page-title-main">Hernia repair</span> Surgical procedures to fix abnormal openings through which tissue or organs may protrude

Hernia repair is a surgical operation for the correction of a hernia—a bulging of internal organs or tissues through the wall that contains it. It can be of two different types: herniorrhaphy; or hernioplasty. This operation may be performed to correct hernias of the abdomen, groin, diaphragm, brain, or at the site of a previous operation. Hernia repair is often performed as an ambulatory procedure.

Claudius Amyand was a French surgeon who performed the first recorded successful appendectomy.

<span class="mw-page-title-main">Umbilical hernia</span> Medical condition

An umbilical hernia is a health condition where the abdominal wall behind the navel is damaged. It may cause the navel to bulge outwards—the bulge consisting of abdominal fat from the greater omentum or occasionally parts of the small intestine. The bulge can often be pressed back through the hole in the abdominal wall, and may "pop out" when coughing or otherwise acting to increase intra-abdominal pressure. Treatment is surgical, and surgery may be performed for cosmetic as well as health-related reasons.

<span class="mw-page-title-main">Spigelian hernia</span> Surgical condition

A Spigelian is the type of ventral hernia where aponeurotic fascia pushes through a hole in the junction of the linea semilunaris and the arcuate line, creating a bulge. It appears in the lower quadrant of the abdomen between an area of dense fibrous tissue and abdominal wall muscles causing a.

Femoral hernias occur just below the inguinal ligament, when abdominal contents pass through a naturally occurring weakness in the abdominal wall called the femoral canal. Femoral hernias are a relatively uncommon type, accounting for only 3% of all hernias. While femoral hernias can occur in both males and females, almost all develop in women due to the increased width of the female pelvis. Femoral hernias are more common in adults than in children. Those that do occur in children are more likely to be associated with a connective tissue disorder or with conditions that increase intra-abdominal pressure. Seventy percent of pediatric cases of femoral hernias occur in infants under the age of one.

An incisional hernia is a type of hernia caused by an incompletely-healed surgical wound. Since median incisions in the abdomen are frequent for abdominal exploratory surgery, ventral incisional hernias are often also classified as ventral hernias due to their location. Not all ventral hernias are from incisions, as some may be caused by other trauma or congenital problems.

Coccygectomy is a surgical procedure in which the coccyx or tailbone is removed. It is considered a required treatment for sacrococcygeal teratoma and other germ cell tumors arising from the coccyx. Coccygectomy is the treatment of last resort for coccydynia which has failed to respond to nonsurgical treatment. Non surgical treatments include use of seat cushions, external or internal manipulation and massage of the coccyx and the attached muscles, medications given by local injections under fluoroscopic guidance, and medications by mouth.

Amyand's hernia is a rare form of an inguinal hernia which occurs when the appendix is included in the hernial sac and becomes incarcerated. The condition is an eponymous disease named after a French surgeon, Claudius Amyand (1660–1740), who performed the first successful appendectomy in 1735.

<span class="mw-page-title-main">Obturator hernia</span> Medical condition

An obturator hernia is a rare type of hernia, encompassing 0.07-1% of all hernias, of the pelvic floor in which pelvic or abdominal contents protrudes through the obturator foramen. The obturator foramen is formed by a branch of the ischial as well as the pubic bone. The canal is typically 2-3 centimeters long and 1 centimeters wide, creating a space for pouches of pre-peritoneal fat.

Single-port laparoscopy (SPL) is a recently developed technique in laparoscopic surgery. It is a minimally invasive surgical procedure in which the surgeon operates almost exclusively through a single entry point, typically the patient's navel. Unlike a traditional multi-port laparoscopic approach, SPL leaves only a single small scar.

Single-incision laparoscopic surgery (SILS) is an advanced, minimally invasive (keyhole) procedure in which the surgeon operates almost exclusively through a single entry point, typically the patient's umbilicus (navel). Special articulating instruments and access ports eliminate the need to place trochars externally for triangulation, thus allowing the creation of a small, solitary portal of entry into the abdomen.

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) is a 501c6 non-profit professional organization providing education on gastrointestinal minimally invasive surgery. It describes itself thus: The mission of the Society of American Gastrointestinal and Endoscopic Surgeons is to innovate, educate and collaborate to improve patient care.

<span class="mw-page-title-main">Inguinal hernia surgery</span> Medical procedure

Inguinal hernia surgery is an operation to repair a weakness in the abdominal wall that abnormally allows abdominal contents to slip into a narrow tube called the inguinal canal in the groin region.

References

  1. ↑ Leite TF; Chagas CAA; Pires LAS; Cisne R; Babinski MA (2016). "De Garengeot's hernia in an 82-year-old man: a case report and clinical significance". J Surg Case Rep. 2016 (7): rjw120. doi:10.1093/jscr/rjw120. PMC   5000838 . PMID   27381019.
  2. ↑ Akopian G, Alexander M (2005). "De Garengeot hernia: appendicitis within a femoral hernia". Am Surg. 71 (6): 526–7. doi: 10.1177/000313480507100617 . PMID   16044937. S2CID   45318879.
  3. ↑ Sharma, H; Jha, PK; Shekhawat, NS; Memon, B; Memon, MA (2007). "De Garengeot hernia: an analysis of our experience" (PDF). Hernia. 11 (3): 235–8. doi:10.1007/s10029-007-0208-5. PMID   17340052. S2CID   20845127. Archived from the original (PDF) on 2013-04-11.
  4. 1 2 Comman A, Gaetzscmann P, Hanner T, Behrend M (2007). "De Garengeot hernia: transabdominal preperitoneal hernia repair and appendectomy". JSLS. 11 (4): 496–501. PMC   3015839 . PMID   18237518.
  5. 1 2 Guenther, Timothy M.; Theodorou, Christina M.; Grace, Nalani L.; Rinderknecht, Tanya N.; Wiedeman, James E. (February 2021). "De Garengeot hernia: a systematic review". Surgical Endoscopy. 35 (2): 503–513. doi:10.1007/s00464-020-07934-5. ISSN   0930-2794. PMC   7855214 . PMID   32880011.
  6. ↑ Bustamante Recuenco, Carlos; García-Quijada García, Javier; Cendrero Martín, Manuel; Carabias Hernández, Alberto; Serantes Gómez, Ana; Sanz Muñoz, Paloma; Delgado Millán, Miguel Ángel; Jover Navalón, José María (2019). "De Garengeot's hernia: Case report and literature review". International Journal of Surgery Case Reports. 64: 58–61. doi:10.1016/j.ijscr.2019.09.037. ISSN   2210-2612. PMC   6796716 . PMID   31605980.


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