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Inguinolabial hernia containing ovary, fallopian tube and uterus in female children

Anjum N. Bandarkar, Adebunmi O. Adeyiga, David Reynolds, Tara Cielma, Nabile Safdar, Eglal Shalaby-Rana

Background: Inguinolabial hernia is a common cause of groin swelling in young female children. This study aimed to describe the sonographic appearance and frequency of inguinolabial hernia containing ovary, fallopian tube, and uterus in female children. Methods: Using a radiology search engine, all female children less than 2 years of age who underwent sonography for groin swelling over a 7-year period were retrospectively reviewed. Results: Of 38 patients (mean age 9.2 months) with groin swelling, 31 (82%, mean age 1.9 months) had an inguinal hernia while 7 (18%, mean age 16.5 months) had other etiologies. The hernia sac contained ovary and/or fallopian tube in 26/31 patients (84%), 9 of whom also had the uterus in the sac. Four cases had a male gonad; these were later proven to have androgen insensitivity syndrome (AIS). The bowel was present in only one case. Other etiologies were abscess (n=1), lymphadenitis (n=3), and hydrocele of Canal of Nuck (n=3). Correct sonographic diagnosis was made prospectively in 36/38 cases and retrospectively in 2 cases. All inguinal hernias were successfully treated. Conclusions: Ovary, fallopian tube, and uterus were the most common contents of the hernia sac, with bowel rarely present. Sonography accurately depicted reproductive organs in the hernia and also helped to exclude other causes of inguinolabial swelling.