title: A combined Richter's and de Garengeot's hernia.
abstract: BACKGROUND
  de Garengeot's hernia is very rare. Richter's hernia is responsible for 10% of acute strangulated hernias.
  
  
  METHODS
  A 91-year-old woman with three days of abdominal distention was found on computed tomogram to have an incarcerated femoral hernia. Operation revealed a de Garengeot's hernia combined with a Richter's hernia of small bowel. Primary repair was performed along with appendectomy.
  
  
  CONCLUSIONS
  We discuss these rare hernias, not previously reported in combination, and options for management.
  
  
  CONCLUSIONS
  Combined de Garengeot's and Richter's hernias are rare, represent a significant diagnostic challenge, and should be repaired urgently to prevent ischemic bowel, or limit contamination if ischemia is already present. Use of computed tomography will likely lead to increased pre-operative diagnosis of this rare entity.
authors.affiliation: Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, United States.
authors.forename: Hau D
authors.initials: HD
authors.lastname: Le
authors.affiliation: Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, United States. Electronic address: sodom@bidmc.harvard.edu.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Odom
authors.affiliation: Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, United States.
authors.forename: Albert
authors.initials: A
authors.lastname: Hsu
authors.affiliation: Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, United States.
authors.forename: Alok
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, United States.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Hauser
keywords: Femoral hernia; Hernia; Richter; de Garengeot