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Journal of Nippon Medical School

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-Case Reports-

Right Inguinal Hernia Encompassing the Uterus, Right Ovary and Fallopian Tube in an Elderly Female: Case Report

Junji Ueda1, Hiroshi Yoshida1, Hiroshi Makino1, Hiroshi Maruyama1, Tadashi Yokoyama1, Atsushi Hirakata1, Ichiro Akagi1, Manabu Watanabe3, Eiichi Uchida3 and Eiji Uchida2

1Department of Surgery, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
2Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan
3Uchida Hospital, Tokyo, Japan


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.

J Nippon Med Sch 2016; 83: 93-96

Keywords
inguinal hernia, uterus, operation

Correspondence to
Junji Ueda, Department of Surgery, Nippon Medical School Tama Nagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo 206-8512, Japan
junji0821@nms.ac.jp

Received, June 15, 2015
Accepted, December 10, 2015