Abstract
Inguinal hernias containing the appendix are rare, but even more exceptional is the occurrence of complicated appendicitis within the hernial sac with a cutaneous fistula. We report the case of a man in his 50s presenting to the emergency department with a right-sided erythematous and painful inguinal swelling secreting seropurulent material. A perforated appendix within an inguinal hernia complicated by an appendico-cutaneous fistula was diagnosed.