Irreducible indirect inguinal hernia containing uterus and bilateral adnexa in a premature female infant: Report of an exceptional case and review of the literature


      Indirect inguinal hernia is the most common congenital anomaly in the pediatric age group. About 15–20% of hernias in infant girls contain ovary, sometimes with a Fallopian tube. The presence of the uterus incarcerated with the adnexa is a very unusual occurrence in female infants with normal kariotype and phenotype, being commonly associated with several disorders of sex development. The surgical repair of this form of hernia is more difficult than a common herniorrhaphy because of the adhesions between the organs and the wall of the sac and the risk of damage during their freeing. We present a rare case of irreducible indirect inguinal hernia containing uterus and bilateral adnexa (fallopian tubes and ovaries) in a premature female infant, discussing the etiopathogenesis and the surgical features of this disorder.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Pediatric Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • George E.K.
        • Oudesluys-Murphy A.M.
        • Madern G.C.
        • et al.
        Inguinal hernias containing the uterus, Fallopian tube, and ovary in premature female infants.
        J Pediatr. 2000; 136: 696-698
        • Okada T.
        • Sasaki S.
        • Honda S.
        • et al.
        Irreducible indirect inguinal hernia containing uterus, ovaries, and Fallopian tubes.
        Hernia. 2012; 16: 471-473
        • Ming Y.C.
        • Luo C.C.
        • Chao H.C.
        • et al.
        Inguinal hernia Containing Uterus and Uterine Adnexa in Female infants: Report of Two Cases.
        Pediatr Neonatol. 2011; 52: 103-105
        • Boley S.J.
        • Cahn D.
        • Laur T.
        • et al.
        Irreducible ovary: a true emergency.
        J Pediatr Surg. 1991; 26: 1035-1038
        • Fowler C.L.
        Sliding inguinal hernia containing both ovaries.
        J Pediatr Surg. 2005; 40: E13-E14
        • Wiley J.
        • Chavez H.A.
        Uterine adnexa in inguinal hernia in infant females: report of a case involving uterus, both uterine tubes and ovaries.
        West J Surg Obstet Gynecol. 1957; 65: 283-285
        • Kamio H.
        • Nagata T.
        • Yamasaki H.
        • et al.
        Inguinal hernia containing functioning, rudimentary uterine horn and endometriosis.
        Obstet Gynecol. 2009; 113: 563-566
        • Gnidec A.A.
        • Marshall D.G.
        Incarcerated direct inguinal hernia containing uterus, both ovaries and fallopian tubes.
        J Pediatr Surg. 1986; 21: 986
        • Bijnens E.
        • Broeckx J.
        • Hoffbauer R.
        • et al.
        Sonographic diagnosis of an incarcerated inguinal hernia containing uterus and left adnexa.
        J Ultrasound Med. 1992; 11: 249-250
        • Jedrzejewski G.
        • Stankiewicz A.
        • Wieczorek A.P.
        Uterus and ovary hernia of the canal of Nuck.
        Pediatr Radiol. 2008; 38: 1257-1258
        • Kocku A.
        • Malazgirt Z.
        • Cetinkaya M.B.
        • et al.
        Presence of a uterine horn and fallopian tube within an indirect hernia sac: report of a rare case.
        Hernia. 2010; 14: 325-327
        • Al Omari W.
        • Hashimi H.
        • Al Bassam M.K.
        Inguinal uterus, fallopian tube, and ovary associated with adult Mayer-Rokitansky-Küster-Hauser syndrome.
        Fertil Steril. 2011; 95: 1119.e1-1119.e4