DOI: http://dx.doi.org/10.18203/2349-2902.isj20191266

Study of contents of inguinal hernia in girls

Kishor Mankar, Nandkishor Shinde, Mohammed Moinuddin, Ashfaq Ahmed

Abstract


Background: Inguinal hernia in females is relatively uncommon as compared to males. In female patients, the hernial sac contains one ovary in approximately 15–20% of cases, and some also contain a fallopian tube. This study was done to know the contents in inguinal hernia in girls.

Methods: A prospective study on eight girls with inguinal hernia presenting between January 2016 to December 2018, presented with swelling in inguinal region. Physical examination in all girls was done followed by ultrasonogram to know the content of inguinal hernia. All patients underwent surgical exploration.

Results: Among 8 girls with inguinal hernia, 2 (25%) girls had bilateral inguinal hernia, 4(50%) girls had right and 2 (25%) girls had left sided inguinal hernia. Ultrasonogram showed 2 girls with bilateral inguinal hernia had intestines as content on both sides. 3 girls had intestines, one (10%) girl had omentum and 2 (20%) girls had ovary as content of hernia sac. On surgical exploration one girl had omentum, one had ovary, two had intestine as hernial sac content. Two girls with irreducible hernia had omentum and ovary respectively as hernial content. In all girls after reduction of content, herniotomy was done.

Conclusions: Surgical repair should be done at diagnosis in all girls presenting with inguinal hernia in view of high incidence of incarceration of ovary and tubes. Sac must be opened and its contents examined before it is tied off and excised.


Keywords


Inguinal hernia, Hernial contents, Ultrasonogram, Surgical exploration

Full Text:

PDF

References


Read RC, White JJ. Inguinal herniation 1777–1977. Am J Surg. 1978;136:651–7.

Devlin HB. Inguinal hernia in babies and children. In: Dudley H, Walter P, Carter D, editors. Rob & Smith operative surgery. 4th ed. Butterworths; 1983: 449–454.

Cascini V, Lisi G, Renzo DD, Pappalepore N, Chiesa PL. Irreducible indirect inguinal hernia containing uterus and bilateral adnexa in a premature female infant: report of an exceptional case and review of the literature. J Pediatr Surg, 2013;48:17-9.

Ando H, Kaneko K, Ito F, Seo T, Ito T. Anatomy of the round ligament in female infants and children with an inguinal hernia. Br J Surg. 1997;84(3):404- 5.

Mollaeian M, Mollaeian A, Ghavami Adel M, Abdullahi A, Torabi B. Preserving the continuity of round ligament along with hernia sac in indirect inguinal hernia repair in female children does not increase the recurrence rate of hernia. Experience with 217 cases. Pediatr Surg Int. 2012;28(4):363-6.

Ozbey H, Ratschek M, Schimpl G. Ovary in hernia sac: prolapsed or descended gonad? J Paedtr Surg. 1999;34(6):977–80.

Hughes IA, Davies JD, Bunch TI, Pasterski V, Mastroyannopoulou K, MacDougall J. Androgen insensitivity syndrome. Lancet. 2012;380:1419–28.

Cheikhelard A, Morel Y, Thibaud E, et al. Long-term follow up and comparison between genotype and phenotype in 29 cases of complete androgen insensitivity syndrome. J Urol. 2008;180:1496–501.

Gil AT, Salgado M. Bilateral inguinal hernia in a female child. BMJ Case Rep. 2014: 1136.

van den Berg JC, de Valois JC, Go PM, Rosenbusch G. Detection of groin hernia with physical examination, ultrasound, and MRI compared with laparoscopic findings. Invest Radiol. 1999;34(12):739–73.

Jamadar DA, Franz MG. Inguinal region hernias. Ultrasound Clin. 2007;2(4):711–25.

Jamadar DA, Jacobson JA, Morag Y, Girish G, Ebrahim F, Gest T, et al. Sonography of inguinal region hernias. AJR Am J Roentgenol. 2006;187(1):185–90.

Korenkov M, Paul A, Troidl H. Color duplex sonography: diagnostic tool in the differentiation of inguinal hernias. J Ultrasound Med. 1999;18(8):565–8.

Chawla S. Inguinal Hernia In Females. Med J Armed Forces India. 2001;57(4):306–8.

Jun Z, Juntao G, Shuli L, Li L. A comparative study on trans-umbilical single-port laparoscopic approach versus conventional repair for incarcerated inguinal hernia in children. J Minim Access Surg. 2016;12:139–42.

Herrington JK. Occult inguinal hernia in the female. Ann Surg. 1975;181:481-3.

Fowler CL. Sliding indirect hernia containing both ovaries. J Pediatr Surg. 2005;40(9):e13-4.

Osifo OD, Ovueni ME. Inguinal hernia in Nigerian female children: beware of ovary and fallopian tube as contents. Hernia. 2009;13(2):149-53.

Ozkan OV, Semerci E, Asian E, Ozkan S, Dolapcioglu K, Besirov E. A right sliding indirect inguinal hernia containing paraovarian cyst. Fallopian tube and ovary: a case report. Arch Gynecol Obstet. 2009;279(6):897-9.

Vagholkar K, Iyengar M, Vagholkar S. Inguinal hernia in females: do we know enough? Int Surg J. 2016;3(1):354-6.

Raveenthiran V, Agarwal P. Choice of Repairing Inguinal Hernia in Children: Open Versus Laparoscopy. Indian J Pediatr. 2017;84(7):555–63.

Nevbahar A, Degirmenci, Özkan IR, Ilhan H, Inguinal kanalda torsiyone over. Tanisal ve Girisimsel Radyoloji. 2003;9:388–90.

Shalev J, Mashiach R, Bar-Hava I, Girtler O, Bar J, Dicker D, et al. Subtorsion of the ovary: sonographic features and clinical management. J Ultrasound Med. 2001;20(8):849–54.

Bronsther B, Abrams MW, Elboim C. Inguinal hernias in children: a study of 1,000 cases and a review of the literature. J Am Med Women's Assoc. 1972;27(10):522–5.

Boley SJ, Cahn D, Lauer T, Weinberg G, Kleinhaus S. The irreducible ovary: a true emergency. J Pediatr Surg, 1991;26(9):1035–8.