Rapid Evaluation of an Inguinal Mass in a Female Infant Using Point-of-Care Ultrasound

Abstract

A 35-day-old female infant presents to the pediatric emergency department with increased crying and persistent fullness in the right groin. On examination, the infant was noted to have increased fullness and a nonreducible mass in the right mons pubis. Point-of-care ultrasound was used to help diagnose an incarcerated ovary, allowing for expedited care while waiting for confirmatory imaging. The infant underwent surgery with salvage of the ovary.

Infant with Groin Swelling

“…3 Ultrasound will differentiate the contents of the hernia sac and determine whether appropriate blood flow is present if an ovary is involved. 4 An irreducible ovary is at higher risk for ovarian torsion, given alteration of anatomy, and should be treated as a surgical emergency. 5…”

Labial Mass in an Irritable 35-Day-Old Female

“…10,11 In addition to ovarian infarction, ovarian torsion has been associated with sudden death in 2 case reports. 15 When ovarian involvement is present, ultrasound has been reported to give an accurate diagnosis in 67.7% to 100% of cases. 14 Ultrasound is the recommended diagnostic tool for pediatric inguinal and pubic masses.…”

“…14 Ultrasound is the recommended diagnostic tool for pediatric inguinal and pubic masses. 15 When ovarian involvement is present, ultrasound has been reported to give an accurate diagnosis in 67.7% to 100% of cases. 14,16,17 If ovary herniation is suspected, confirming ovary viability and other tissue in the hernia sac with an ultrasound study prior to attempting manual reduction is recommended.…”