Kamio Masaki, Nagata Tomomi, Yamasaki Hideki, Yoshinaga Mitsuhiro, Douchi Tsutomu
From the Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan.
Obstet Gynecol. 2009 Feb;113(2 Pt 2):563-566. doi: 10.1097/AOG.0b013e3181942068.
Inguinal hernia containing uterus and endometriosis is exceedingly rare. Most inguinal endometriosis is located at an extrapelvic site near the round ligament. We report a case of a patient with inguinal hernia containing rudimentary uterine horn and endometriosis.
A young, nulliparous, regularly menstruating woman manifested right inguinal mass and pain in the mass during menstruation. At 20 years old, she underwent a surgical procedure for right inguinal mass. Postoperative pathology findings demonstrated inguinal endometriosis. Based on the findings of magnetic resonance imaging, a history of inguinal endometriosis, and the occurrence of inguinal pain during menstruation, she was diagnosed as having incarcerated inguinal hernia containing anomalous uterus and endometriosis. A functioning, noncommunicating, rudimentary uterine horn and endometriosis were surgically removed from the hernia sac. Laparoscopy demonstrated intraabdominal unicornuate uterus, but no pelvic endometriosis.
Functioning, incarcerated hernia uterus inguinale may be associated with müllerian abnormality and concomitant occurrence of inguinal endometriosis.
含有子宫和子宫内膜异位症的腹股沟疝极为罕见。大多数腹股沟子宫内膜异位症位于圆韧带附近的盆腔外部位。我们报告一例含有残角子宫和子宫内膜异位症的腹股沟疝患者。
一名年轻、未生育、月经规律的女性表现为右侧腹股沟肿块,并在月经期间肿块疼痛。20岁时,她接受了右侧腹股沟肿块的手术。术后病理结果显示为腹股沟子宫内膜异位症。根据磁共振成像结果、腹股沟子宫内膜异位症病史以及月经期间腹股沟疼痛的发生情况,她被诊断为嵌顿性腹股沟疝,包含异常子宫和子宫内膜异位症。从疝囊中手术切除了一个有功能、不与外界相通的残角子宫和子宫内膜异位症。腹腔镜检查显示腹腔内单角子宫,但无盆腔子宫内膜异位症。
有功能的、嵌顿性腹股沟疝子宫可能与苗勒管异常及腹股沟子宫内膜异位症的并发有关。