Femoral hernias occur in about 3% of all abdominal wall hernias. Herniation of the appendix through a femoral hernia (called de Garengeot hernia) is even much rare a finding, occurring in 0.5% to 5% of all femoral hernias. Rene De Garengeot, a French surgeon, was the first to describe the presence of the appendix inside a femoral hernia sac in 1731. Less than 100 cases have been reported in literature till date. It may present as a tender and/or erythematous groin swelling and is often misdiagnosed as an incarcerated or strangulated femoral hernia. Being a rare condition, it poses a significant diagnostic challenge pre-operatively. The diagnosis is almost always confirmed intra-operatively due to the similarities it shares with an irreducible inguinal or femoral hernia that requires emergent surgical intervention. A high index of clinical suspicion is necessary as these hernias are at particularly high risk of perforation and so prompt surgical management is paramount.
