Ozkan Orhan Veli, Semerci Ersan, Aslan Erdogan, Ozkan Sebiha, Dolapcioglu Kenan, Besirov Elmir
Department of General Surgery, Mustafa Kemal University, Hatay, Turkey.
Arch Gynecol Obstet. 2009 Jun;279(6):897-9. doi: 10.1007/s00404-008-0807-0. Epub 2008 Oct 4.
Albeit very uncommon, the hernia sac may contain unusual structures such as vermiform appendix, acute appendicitis, ovary, fallopian tube and, urinary bladder. Most of the cases of hernia containing ovary and fallopian tubes were reported to be found in children and, often accompanied with other congenital anomalies of genital tract. We present the first case of sliding inguinal hernia containing right ovary and fallopian tube and a right paraovarian cyst in 80-year-old, multiparous patient without any associated genital anomaly. The hernia was repaired with plication darn, while the paraovarian cyst was excised and adnexa were preserved. It is of utmost importance to keep in mind that the hernia sac may contain almost any abdominal organ, and surgical dissection should be carried out accordingly. Pathophysiologically, the ovary might be simply pulled along with a sliding paraovarian cyst or the paraovarian cyst might be accompanying the maldescended ovary. There seems to be a need for clinical and experimental studies to further explain the mechanisms that apply to the pathogenesis of sliding inguinal hernias.
尽管非常罕见,但疝囊可能包含异常结构,如阑尾、急性阑尾炎、卵巢、输卵管和膀胱。据报道,大多数含有卵巢和输卵管的疝病例见于儿童,且常伴有其他生殖道先天性异常。我们报告了首例80岁经产妇的滑动性腹股沟疝,疝内容物为右侧卵巢、输卵管及右侧卵巢旁囊肿,且无任何相关的生殖道异常。采用褶缝修补术修复疝,同时切除卵巢旁囊肿并保留附件。必须牢记,疝囊可能包含几乎任何腹腔器官,因此应相应地进行手术解剖。从病理生理学角度来看,卵巢可能只是随着滑动的卵巢旁囊肿一起被牵拉,或者卵巢旁囊肿可能伴随卵巢下降不全。似乎需要进行临床和实验研究,以进一步解释适用于滑动性腹股沟疝发病机制的相关机制。