Laugier's Hernia With an Incarcerated Appendix Managed Using a Two-Stage Laparoscopic Approach: A Case Report.

Abstract

Laugier's hernia is a rare atypical femoral hernia in which the hernial sac protrudes through the lacunar ligament, located medial to the femoral ring. To the best of our knowledge, no cases of Laugier's hernia with appendiceal incarceration have been reported to date. A 70-year-old man presented with a right groin mass, and computed tomography revealed an incarcerated appendix within a hernial sac medial to the femoral vessels, with minimal compression of the femoral vein. Laparoscopic appendectomy confirmed appendiceal incarceration, and histopathology revealed phlegmonous appendicitis. Two months later, laparoscopic transabdominal preperitoneal repair confirmed Laugier's hernia, and mesh repair was safely performed. The postoperative course was uneventful with no recurrence or mesh infection. This case highlights the diagnostic utility of computed tomography and the safety of staged laparoscopic management for this rare condition.