Incarcerated femoral hernia with ovary and fallopian tube torsion in an infant: a rare occurrence

Abstract

Incarcerated femoral hernia with ovary and fallopian tube torsion is very rare in children. We herein report a case of incarcerated femoral hernia with ovary and fallopian tube torsion in a 7-month-old female who was diagnosed on the basis of operative findings. We released the torsion of the left fallopian tube. However, the ovary remained discolored. Left salpingo-oophorectomy and McVay repair for femoral hernia were performed. She has experienced no recurrence of femoral hernia for 3 years. We must consider incarcerated femoral hernia in the differential diagnosis for infants with groin redness and swelling.

Groin swelling: Unexpected findings

“…There have been two reported cases in infants (King 1978;Ichinokawa et al 2008) that presented with strangulation.…”

Incarcerated femoral hernia containing ovary and fallopian tube in a 54-year-old

“…They typically present as a painless or painful groin lump, although may present simply as groin pain or with features of their complications such as obstruction. A differential diagnosis for a groin lump in females includes groin hernia (inguinal/femoral/obturator), lymphadenopathy, femoral artery aneurysm/pseudoaneurysm, abscess and subcutaneous tumour (lipoma etc) 5 6…”

“…By comparison, there are only a relatively small number of reports in the world literature of femoral hernias containing ovary contents dating back to 1892. In a detailed search of the world literature, 15 cases of incarcerated femoral hernia containing fallopian tube were identified, of which six cases also contained ovary and three occurred in children 5 6 8–14…”

Incarcerated Femoral Hernia Containing Ipsilateral Fallopian Tube

“…Incarcerated femoral hernia containing fallopian tube is an extremely rare condition, as only three cases have been reported [2–4]. On the other hand, the presence of ovary in the sac of a femoral hernia is more common, with more than 10 cases having been described so far [9]. …”

“…Femoral hernia is best visualized as a hernia in contact with the femoral vein by ultrasonography. Doppler ultrasonography might be helpful to evaluate blood flow of the containing viscera or the anatomic relation between femoral vessels and hernia sac [9, 12]. …”