Herniation of the uterus, ovaries and fallopian tubes into the canal of Nuck in a 4-month-old child: A rare entity

Abstract

Partial or complete failure of obliteration of the processus vaginalis in the female results in the formation of a potential space known as the canal of Nuck, into which various organs and/or collections can herniate. A 4-month-old female presented with a left labial mass related to herniation of the uterus, ovaries and fallopian tubes through the canal of Nuck. Early diagnosis is important as there is a high risk of ovarian torsion and incarceration.

Canal of Nuck Hernia in an Elderly Patient- A Case Report

“…The differential diagnosis is important when we face a large mass from the inguinal region to the labia majora, being non-compressible, without erythema or induration. The possibility of lymphadenopathy, hydrocele, lipoma, Bartholin gland cyst, hemangiomas, epidermal cysts, endometriosis and benign and malignant neoplasm should be investigated in those cases [1,2,[12][13][14][15]. According to the literature, the most common contents in the canal of Nuck hernias are the omentum, ovaries, uterus, fallopian tubes, mesenteric fat and urinary bladder, while the bowel loop herniation is a rare presentation [2,9,10,14,17].…”

“…The canal of Nuck originated from the non-closure of the vaginalis process, which begins to be formed between the 8 th and 12 th week of fetal development and usually completely disappears until the 1 st year of life [1][2][3]. However, in up to 80% of males and 60% of females, the process vaginalis is still present at birth [2].…”

“…This non-obliteration of the vaginalis process in women leads to a protrusion of the parietal peritoneum that passes through the inguinal canal and reaches the labia majora, as described by the anatomist Anton Nuck in 1691 [1,[4][5][6].…”

“…An indirect inguinal hernia is formed, which may contain the omentum, intestinal loops, ovary, uterus, uterine tube, or bladder and can reach up to the labia majora. If the content of the hernia is peritoneal liquid, a hydrocele will be formed if the failure in the closing process is complete and a cyst if it is incomplete [1][2][3][6][7][8].…”

Hernia femoral encarcelada con contenido de ovario

“…El reconocimiento temprano asegura una pronta intervención quirúrgica y previene la lesión de los órganos encarcelados dentro de las hernias. No obstante, la ecografía preoperatoria con transductor de alta frecuencia tiene una eficacia cercana al 100% para identificar el contenido (13) . En algunos casos, las características morfológicas del ovario pueden ser evaluadas por ecografía y/o demostrar la ausencia del ovario ipsilateral a la hernia.…”