Department of Surgery, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
J Med Case Rep. 2024 Sep 18;18(1):436. doi: 10.1186/s13256-024-04763-1.
Finding an ovary and/or fallopian tube within an indirect inguinal hernia is a rare occurrence that can be detected incidentally during elective surgery or present as a medical emergency requiring immediate intervention. Hence, it poses a difficult clinical picture in a reproductive-age woman with groin mass.
We describe the case of a 45-year-old Ethiopian woman of Amhara ethnicity who presented with a left inguinal swelling that persisted for 5 years. Physical examination revealed an irreducible, non-tender lump in the left groin and an ultrasonography scan confirmed the presence of an indirect inguinal hernia. The patient was then scheduled for elective hernia repair. During the surgery, both her left ovary and fallopian tube were found within the hernial sac. The contents were released from the sac, high ligation performed, and the inguinal floor repaired with mesh.
Inguinal hernias in women are rare and often present a diagnostic challenge. Although the exact pathogenesis of inguinal hernias containing female genital organs is unknown, some risk factors have been postulated. Diagnosis should start with a physical exam and imaging, but many of the cases have been intraoperative surprises. Management is primarily surgical, ranging from simple reduction and hernia repair to salpingo-oophorectomy depending on the status of the hernia contents.
This report emphasizes the importance of maintaining a high index of suspicion when examining females with inguinal hernias to ensure accurate diagnosis and management of tubo-ovarian hernias. Although rare, inguinal hernias containing female genital organs should be considered in the differential diagnosis of inguinal hernias, as early detection and appropriate surgical management can prevent potential complications.
在腹股沟疝中发现卵巢和/或输卵管是一种罕见的情况，这种情况可能在择期手术中偶然发现，也可能表现为需要立即干预的医疗紧急情况。因此，对于有腹股沟肿块的育龄妇女来说，这构成了一个困难的临床难题。
我们描述了一位 45 岁的埃塞俄比亚阿姆哈拉族妇女的病例，她因左侧腹股沟肿胀就诊，该肿胀持续了 5 年。体格检查发现左侧腹股沟不可还原的、无触痛的肿块，超声扫描证实存在腹股沟疝。随后患者被安排择期行疝修补术。手术过程中，发现其左侧卵巢和输卵管均位于疝囊内。将内容物从囊中释放，进行高位结扎，并使用网片修复腹股沟底部。
女性腹股沟疝罕见，且常具有诊断挑战性。尽管包含女性生殖器官的腹股沟疝的确切发病机制尚不清楚，但已提出了一些危险因素。诊断应始于体格检查和影像学检查，但许多病例都是术中意外发现。治疗主要是手术，根据疝内容物的情况，范围从简单的复位和疝修补术到输卵管卵巢切除术。
本报告强调了在检查有腹股沟疝的女性时保持高度怀疑的重要性，以确保准确诊断和处理输卵管卵巢疝。虽然罕见，但包含女性生殖器官的腹股沟疝应考虑在腹股沟疝的鉴别诊断中，因为早期发现和适当的手术治疗可以预防潜在的并发症。
