Strangulation of the appendix in a femoral hernia sac.

CASE 1. An 83 year old man presented with a 48 hr history of vomiting and constipation. He was pyrexial, the abdomen was distended, and a tender swelling was present in the medial aspect of the right groin, below the inguinal ligament. A diagnosis of incarcerated femoral hernia was made. Exploration through a McEvedy incision revealed strangulation and necrosis of a loop of small bowel and of the appendix in the hernial sac. Appendicectomy, small bowel resection and repair of the femoral ring were performed. He made an uneventful recovery. Histopathology confirmed appendiceal necrosis and focal necrosis in the small bowel.