Epiploic appendicitis in inguinal hernia sac presenting an inguinal mass.

Inguinal hernia sometimes surprises surgeons with its unexpected content. Epiploic appendagitis in hernia sac is a very rare entity. We report a 60-year-old male patient with a painless inguinal mass. Surgical exploration showed a 4-cm mass beneath the external oblique aponeurosis that consisted of a hernia sac containing an inflamed and remarkably swollen appendix epiploica of the sigmoid colon secondary to torsion. The patient recovered after the resection of epiploic appendix and a tension-free hernia repair.