title: Right Inguinal Hernia Encompassing the Uterus, Right Ovary and Fallopian Tube in an Elderly Female: Case Report.
abstract: The uterus, ovary, and fallopian tube are rarely present in an inguinal hernia. We report on an operation to treat just such a rare condition for a right inguinal hernia. An 87-year-old Japanese woman was admitted with swelling in the right inguinal region and a purulent discharge from the vagina. Vital signs were stable, but the mobile mass was irreducible. Computed tomography of the abdomen indicated uterine tissue in a right inguinal hernia. We diagnosed an inguinal hernia with an incarcerated uterus and performed surgery on that basis. An incision approximately 6 cm long was made in the skin above the swollen area to open the inguinal sac, disclosing a tumor enveloped by a hernial sac. Opening the hernial sac revealed the prolapsed uterus, the fallopian tube, and the right ovary. Because no ischemic change was noted, the incarcerated uterus was returned to the abdominal cavity, and the hernial opening was closed with the onlay mesh technique. The posterior wall of the inguinal canal was found to have prolapsed laterally to the inferior epigastric artery, resulting in an external inguinal hernia. This case demonstrates that careful attention must be paid to inguinal hernias in female patients because the uterus, ovary, and fallopian tube may be involved.
authors.affiliation: Department of Surgery, Nippon Medical School Tama Nagayama Hospital.
authors.forename: Junji
authors.initials: J
authors.lastname: Ueda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Makino
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Maruyama
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirakata
authors.forename: Ichiro
authors.initials: I
authors.lastname: Akagi
authors.forename: Manabu
authors.initials: M
authors.lastname: Watanabe
authors.forename: Eiichi
authors.initials: E
authors.lastname: Uchida
authors.forename: Eiji
authors.initials: E
authors.lastname: Uchida
mesh_terms: D000369:Aged, 80 and over; D005187:Fallopian Tubes / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006552:Hernia, Inguinal / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D010053:Ovary / Q000254:growth & development / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014596:Uterine Prolapse / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D014599:Uterus / Q000000981:diagnostic imaging / Q000473:pathology*