A Rare Case Of Female Left Inguinal Hernia With Ovary As A Content And Mullerian Agenesis
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Abstract
Herniation of the ovary through the inguinal canal is an uncommon clinical entity, predominantly seen in pediatric patients and rarely encountered in adult females. Its clinical features as an irreducible or painful inguinal swelling, often leading to diagnostic uncertainty and an increased risk of ovarian compromise. This case report describes a 19-year-old female who presented with a painful left inguinal swelling associated with intermittent lower abdominal discomfort for the past 3-4 days. Clinical examination revealed a tender, irreducible mass in the left inguinal region with no features of intestinal obstruction. Ultrasonography demonstrated herniation of the left ovary within the inguinal canal, with preserved vascularity, confirming the diagnosis and excluding bowel involvement. Pelvic imaging further revealed absence of the uterus with bilateral hypoplastic ovaries, suggestive of Müllerian agenesis.
The patient underwent surgical exploration, which revealed a left indirect inguinal hernia containing the left ovary. After careful intraoperative assessment, oophorectomy was performed. This was followed by transabdominal preperitoneal repair of the left inguinal hernia along with bilateral oophorectomy. Postoperative management included analgesia, antibiotics, and routine wound care, resulting in an uneventful recovery and satisfactory clinical outcome.
The presence of ovarian structures within an inguinal hernia necessitates prompt surgical intervention to prevent complications such as torsion, ischemia, and irreversible loss of reproductive function. A high index of suspicion, appropriate preoperative imaging, and meticulous intraoperative decision-making are essential, particularly in women of reproductive age. Early diagnosis and timely surgical management ensure favourable outcomes and help minimize avoidable morbidity in this rare clinical presentation.
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