Perforated appendicitis within paraumbilical hernia

The appendix is not uncommonly encountered within an external hernial sac. However, acute appendicitis in hernia is quite rare. We report a female patient who was admitted and operated as a case of incarcerated, strangulated paraumbilical hernia and the hemial sac was found to contain part of the greater omentum, pus and acutely inflamed, gangrenous appendix, perforated at the tip. Appendicectomy and hernial repair were carried out through the same incision