Background: A 70-year-old man was referred to our hospital with increasing pain and tenderness over a pre-existing right inguinal hernia, which had been present for the past 12 years. On clinical examination, there was an irreducible inguinal bulge and a tender palpable mass at the right groin. Laboratory results revealed a normal leukocytosis (6.800/mm3) and a normal CRP of 0.1 mg/dl. CT scan was performed, followed by appendectomy during ‘routine’ inguinal herniorraphy.