Abstract
De Garengeot hernias are rare surgical occurrences and even more so when the histopathology reveals acute appendicitis. Varying approaches are documented with regards to open versus laparoscopic and the use of mesh. This case demonstrates the successful use of an open high McEvedy approach with primary suture closure in an elderly female who presented with an acute history of a right groin lump, right iliac fossa pain, nausea and fever.