Rare and unusual case of perforated appendicitis in a Spigelian hernia.

1. Amyand hernia is a rare phenomenon, defined as an inguinal hernia containing the vermiform appendix. It is seen in less than 1% of inguinal hernias. Claudius Amyand first reported this interesting finding in 1735.2. De Garengeot hernia: this is the clinical finding of the vermiform appendix within a femoral hernia sac; it occurs in less than 1% of all femoral hernias and is named after the French surgeon, Rene Jacques Croissant de Garengeot.3. Unnamed: The clinical entity we describe in this case report is the last of the ‘appendix in a hernia—yet to be eponymously named’. It is an interesting and intriguing clinical finding, yet without a referenced name it does not immediately come to mind as a potential differential diagnosis. Medical historians may well commence the search for the first description of the condition.An 83-year-old woman was admitted to the surgical triage unit of a teaching hospital with a 10-day history of worsening right-sided abdominal pain. This was associated with a 4-day history of diarrhoea and fullness in her right lower quadrant of the abdomen. She reported nausea but no vomiting and associated fevers for the preceding 2 days in community. Systemic enquiry revealed no further symptoms. Medical history included hypertension and a caesarean section.On physical examination, the …