Ovarian torsion within an incarcereted inguinal hernia; Ultrasound and color Doppler findings

Abstract

SUMMARYInguinal hernias can be seen in childhood approximately with a range between 0.8 and 4.4 %. In female patients, in 15% to 20% of cases there is an ovary with or without Fallopian tube in the inguinal hernia. In this paper, a case of 6 months old female patient presented with ovary containing inguinal hernia and ovarian torsion is presented. In cases of incarcerated ovary containing inguinal hernia prompt diagnosis and surgical reduction are very important to prevent ovarian torsion and ischemia. Ultrasound and/or Color Doppler Ultrasound play a crucial role in diagnosing hernia content as ovarian tissue and ovarian torsion, if happens. Keywords: Inguinal hernia, ovary, torsion ÖZET Çocukluk çağında inguinal herni görülme sıklığı %0.8 ile 4.4 arasında değişmektedir. Kadın hastalarda %15-20 vakada inguinal herni kesesi içerisinde Fallop tüpü ile beraber ya da tek başına over bulunmaktadır. Vaka: Bu vaka raporunda 6 aylık bir kız çocuğunda görülen ve torsiyone over içeren inkarsere inguinal herni vakası görüntüleme bulguları ile sunulacaktır.Tartışma: Over içeren inkarsere inguinal herni vakalarında hızlı tanı ve acil tedavi , olası bir over torsiyonunu/nekrozunu önlemek açısından önemli rol oynamaktadır. Ultrason ve Renkli Doppler Ultrason herni kesesi içinde over varlığını göstermede ve olası bir torsiyona tanı koymada etkin ve önemli görüntüleme metodlarıdır.

Sliding Inguinal Hernia with Ovarian Gangrene in an Infant of Minimal Age: A Case Report

“…This arrangement may simulate the 'bellclapper' deformity, which is well known in spontaneous testicular torsion situations [15]. At the beginning, torsions can affect venous drainage, in turn leading to a decrease in arterial supply and end with ischemia and gangrene [16]. however, many pediatric surgeons stand against the view of the role of elective surgery for incarcerated herniated ovary based on its condition whether strangulated or reducible, but the fact imposes an urgent surgical intervention in case of ovarian prolapse in hernia sac due to the relatively narrow pedicle and extensively liable for incarceration and gangrene is to avoid losing a reproductive organ like the ovary or the fallopian tube [12].…”

Strangulated ovarian inguinal hernia in a female infant Case report

“…This arrangement may mimics the "bellclapper" deformity well-described in the event of spontaneous testicular torsion 10 . Torsion well press on the venous side initially than arterial supply diminished and eventually ischemia and gangrene developed 11 .…”