De Garengeot Hernia Presenting as a Rare Cause of Incarcerated Femoral Hernia.

De Garengeot hernia is defined as the presence of the appendix within a femoral hernia sac and represents a rare surgical condition. Its clinical presentation closely resembles that of an incarcerated or strangulated femoral hernia, often leading to delayed or intraoperative diagnosis. We report the case of an elderly woman who presented with acute right-groin pain and an irreducible groin mass concerning for an incarcerated femoral hernia. Emergent open exploration through an inguinal approach revealed a gangrenous appendix within the femoral canal. Appendectomy and primary tissue repair were performed, and the patient recovered uneventfully. Due to nonspecific clinical findings, De Garengeot hernia is most frequently diagnosed intraoperatively. Computed tomography may assist in preoperative diagnosis when a blind-ended tubular structure contiguous with the cecum is identified within the femoral canal. Prompt surgical intervention is essential to prevent perforation and infectious complications. While laparoscopic repair may be considered in selected stable patients, open exploration remains the standard approach in emergency settings. Maintaining a high index of suspicion for De Garengeot hernia in elderly women presenting with irreducible groin masses allows for timely diagnosis and definitive surgical management with excellent outcomes.