Epiploic Appendagitis in an Incarcerated Inguinal Hernia: A Case Report and Literature Review.

Epiploic appendagitis (EA) is a rare and frequently overlooked cause of abdominal pain. EA within the sigmoid colon in a right-sided inguinal hernia is a rare entity with only a few cases reported. In this article, we present a case of an 80-year-old male with a palpable mass within an incarcerated right inguinal hernia. The patient underwent urgent surgical intervention due to incarceration and the operative findings were of a large indirect inguinoscrotal hernia containing sigmoid colon, with an inflamed epiploic appendage. The colon was reduced into the abdominal cavity and standard tension-free Lichtenstein repair was performed. EA should be a consideration in patients with an acute abdomen as well as those with a painful groin lump. CT is diagnostic; however, emergency surgery should not be delayed for a scan if the hernia is irreducible and tender.