Appendicitis in incarcerated femoral hernia

Background: Femoral hernia can rarely present with the content of appendicitis. We report on an elderly female who was admitted to our emergency department with a painful groin mass. Methods: An 85-year-old woman presented with a 7-day history of right groin pain and swelling. She also had complaints of nausea, vomiting, and right lower quadrant abdominal pain. Physical examination revealed a right groin mass in the femoral region, which was painful on examination. Abdominal examination ended with normal findings except bilateral lower quadrant tenderness. Ultrasonographic examination revealed a hernia sac containing suspected aperistaltic bowel segment with edematous wall. Results: The patient underwent surgery. During exploration of the right groin region, a strangulated femoral hernia sac containing appendicitis was detected. Conclusion: Surgeons should be aware of the existence of this kind of atypical presentation of appendicitis.