Background: Inguinal hernia is one of the common congenital conditions among pediatric age groups with an estimated incidence of 1 -2% in mature infants and up to 30% in premature infants. The risk of incarceration of testis, bowel, or ovary in children with inguinal hernia is about 3-16%. Therefore, repair of the inguinal hernia is necessary to prevent such complications. However, only a few cases of the hernia sac contain both the ovaries and the uterus at the same time. If reduction of the hernia is not performed in a timely manner, the symptoms will worsen, tissue necrosis and gangrene will ensue.Case presentation: Parents brought a 45 days old healthy baby to the emergency department for a history of sudden enlargement of the left inguinal swelling that forced the baby to cry continuously, the history, physical examination and investigations revealed incarcerated left inguinal hernia, emergency intervention was performed under general anesthesia, findings were left ovarian torsion, gangrene, and necrosis inside the indirect inguinal hernia sac, left salpingo-oophorectomy was done, histopathological result confirmed the diagnosis.
Conclusion:There is a strong likelihood that inguinal hernias containing the ovary in females pose a substantial risk of torsion and strangulation. Timely intervention should be recommended without delay.