An Indirect Inguinal Hernia in a Neonate Containing the Uterus, Ovary, and Fallopian Tube: A Report of a Rare Case and a Literature Review

TL;DR

A rare case of a neonate with an inguinal hernia containing the uterus, ovary, and fallopian tube is reported, highlighting the importance of early diagnosis and surgical intervention.

Contribution

This paper presents a rare clinical case of a neonate with a unique hernia containing reproductive organs, adding to the limited literature on this condition.

Findings

A 10-day-old neonate had an inguinal hernia containing the uterus, ovary, and fallopian tube.

Surgical reintegration of the organs was successful with no complications.

High-resolution ultrasound is recommended for early diagnosis of herniated structures in neonates.

Abstract

An indirect inguinal hernia is a commonly seen congenital condition that can impact infants within their first year of life. An inguinal hernia arises when a portion of the intestines, omentum, or reproductive structures herniate into the scrotal sac or labia through the patent processus vaginalis. These hernias occur more frequently in preterm newborns. The contents of a hernia often consist of the small bowel, colon, omentum, and either the ovary or testicle. The occurrence of a uterus in a herniated sac is uncommon. The presence of a uterus, ovary, and fallopian tube is exceptionally rare, with only a few cases reported in the literature.

We present a unique case of a 10-day-old female neonate who was delivered at 37 weeks of gestation and brought to the Paediatric Outpatient Department with swelling in the left inguinal region that had been present for the past five days. During the clinical examination, an irreducible mass was found in the left inguinal region. The ultrasound scan showed the uterus, ovary, fallopian tube, and minimal free fluid in the herniated sac. Colour Doppler evaluation of the uterus and ovaries revealed good vascularity. A diagnosis of a left inguinal hernia containing the uterus, left ovary, and fallopian tube, with no signs of ovarian torsion, was established. We performed a surgical procedure in which the likelihood of adhesions was taken into consideration, and the organs were removed from the hernial sac. We conducted the reintegration of the organs back into the pelvis, ligation of the high sac, and further repair of the internal inguinal ring to prevent the recurrence of the hernia. The surgical procedure was successful, and the postoperative period was without any complications. After the surgery, the patient was advised to have clinical and radiological follow-up for a period of one year. We recommend that a high-resolution ultrasound (HRUS) scan be routinely performed in neonates with an asymptomatic or symptomatic palpable mass in the inguinal region for early diagnosis and characterization of the herniated structures, as well as to assess their viability.

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