Kumar Anurag, Kumar Anil, Anwer Majid, Kumar Deepak
Department of Trauma Surgery & Critical Care, All India Institute of Medical Sciences, Patna, India.
Department of Trauma Surgery & Critical Care, All India Institute of Medical Sciences, Patna, India.
Int J Surg Case Rep. 2023 Feb;103:107895. doi: 10.1016/j.ijscr.2023.107895. Epub 2023 Jan 11.
Presence of ovary in an inguinal canal in adult female is a rare presentation. Most of the cases are associated with congenital abnormalities of the female genital tract. The incidence of mullerian agenesis decreases with increasing age. The presence of bilateral inguinal hernia with ovaries as a content in an adult female is extremely rare.
A 21 year old female presented with bilateral groin swelling with associated pain on left side. On evaluation, there was inguinal hernia on both sides, of which left sided was irreducible. The ultrasonography of groin showed uterus and ovary as contents on left sided sac and ovary on the right side. Considering the severe pain and irreducibility on left side, the exploration of bilateral inguinal regions was done. On exploration, the biopsy was taken and the contents were repositioned back into the pelvis.
The presence of ovary, uterus or both in the inguinal canal is extremely rare in an adult female. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is characterized by normal secondary sexual character with agenesis of uterus and vagina. Karyotype of individual female is essentially 46XX. Early diagnosis is essential to prevent the complications. The primary treatment of irreducible inguinal hernia is exploration and repositioning the contents back to pelvis if grossly normal and repair of inguinal hernia at earliest.
A case of bilateral inguinal ovarian hernia with irreducibility in an adult female requires an urgent exploration. Delaying the intervention may result in obstruction, strangulation, and subsequent infertility.
成年女性腹股沟管内存在卵巢是一种罕见的表现。大多数病例与女性生殖道的先天性异常有关。苗勒管发育不全的发病率随年龄增长而降低。成年女性双侧腹股沟疝且疝内容物为卵巢极为罕见。
一名21岁女性因双侧腹股沟肿胀伴左侧疼痛就诊。评估发现双侧腹股沟疝，其中左侧为不可复性疝。腹股沟超声检查显示左侧疝囊内有子宫和卵巢，右侧为卵巢。鉴于左侧疼痛剧烈且不可复性，遂对双侧腹股沟区域进行探查。探查时取了活检，并将疝内容物复位回盆腔。
成年女性腹股沟管内存在卵巢、子宫或两者均存在极为罕见。迈耶-罗基坦斯基-库斯特-豪泽（MRKH）综合征的特征是第二性征正常，但子宫和阴道发育不全。个体女性的核型基本为46XX。早期诊断对于预防并发症至关重要。对于不可复性腹股沟疝，主要治疗方法是进行探查，若疝内容物大体正常则将其复位回盆腔，并尽早修复腹股沟疝。
成年女性双侧腹股沟卵巢疝且不可复性的病例需要紧急探查。延迟干预可能导致梗阻、绞窄及随后的不孕。
