Incarcerated Femoral Hernia and the Ovary Found Within It

Matias J Nauts, DO, Linda Szczurek, DO, Margaret Merriam, DO, Marc Neff, MD

University of Medicine and Dentistry of New Jersey

Introduction: A femoral hernia containing an ovary, a rare occurrence, is often diagnosed intra-operatively. In a literature review, few references to this phenomenon have been described. These patient may present with a myriad of symptoms, including pain, nausea, vomiting, intestinal obstruction, and a palpable groin mass.

Methods: In this case report we discuss an 80 year old female with complaints of abdominal pain and vomiting, found to have an ovary incarcerated in a femoral hernia. Diagnosis of incarcerated inguinal hernia was proposed by Computed Tomography, but ultimately definitive diagnosis was made intra-operatively through the use of laparoscopy.

Results: Laparoscopic approach was used to investigate the left inguinal canal which failed to demonstrate incarcerated small bowel but rather an ovary trapped in the femoral canal. Unsuccessful attempts were made to reduce the ovary, leading to conversion to an open procedure. The ovary was reduced and a mesh plug inserted in to the defect. Laparoscopy was further utilized to examine the reduced ovary once back in its intra-peritoneal position.

Conclusion: Femoral Hernias are relatively rare with an incidence of 2-8% in the adult population. Only a few case reports have described an ovary being incarcerated within a femoral hernia. Management dictates reduction of the femoral hernia contents and repair of the defect. Whether an open procedure or laparoscopic procedure is superior still is to be seen. Laparoscopy allows for greater visibility and assessment of structures deep in the pelvis, which may be difficult to obtain in an open manner. Furthermore, the shortened in-patient hospital stay, and hastened recovery makes this approach attractive, albeit being more technically demanding, but with the increasing experience and expertise being gained in laparoscopic surgery, a feasible one.

Session: Poster Presentation

Program Number: P298

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