SONOWORLD : Nonreducible inguinal hernia containing the right ovary

Username

Password

177,065 Registered Members as of 10/23/2019.

JavaScript must be enabled in order for you to use Sonoworld.com in standard view. However, it seems JavaScript is either disabled or not supported by your browser. To use standard view, enable JavaScript by changing your browser options, then try again.

Musculoskeletal » Superficial

Nonreducible inguinal hernia containing the right ovary

« Back to Listing

Author(s) :

Taco Geertsma, MD

Presentation Four weeks old girl with a palpable mass in the right groin

Caption: Detail of the palpable mass

Description: The image shows a solid lesion with tiny cystic structures. The small cysts are the follicles in a normal ovary

Caption: Longitudinal view of the groin

Description: This longitudinal view of the groin shows an intrabdominal extension of the lesion consistent with an inguinal hernia

Caption: Transverse view of the groin

Description: The Transverse view of the groin shows an intrabdominal extension of the lesion consistent with an inguinal hernia

Caption: Color Doppler image of the lesion

Description: This color doppler image shows the normal vascularity of the right ovary

Caption: Transverse image with color Doppler of the lesion

Description: This color doppler image shows the normal vascularity of the right ovary. Also flow in the epigastric artery and vein (round vessels) can be identified. The vessels entering the hernia run lateral to the epigastric vessels. This means it is a lateral or indirect inguinal hernia

Differential Diagnosis Differential diagnosis of a palpable mass in girls are
- Nuck cyst or hydrocele.
- Inguinal lymphe node
- Inguinal hernia.
- Soft tissue tumors

Final Diagnosis nonreducible inguinal hernia containing the right ovary

Discussion

A Nuck cyst or hydrocele is a cystic non vascularized lesion in a typical location.

Inguinal lymphe nodes are solid structures although necrosis or abscess formation can result in cystic areas. They are often multiple and show no intra abdominal extension.

Inguinal hernia. Inguinal hernias can be differtiated accordind to
Location: in a medial (direct) or lateral (indirect ) inguinal hernia
Effect of compression: Reducible or nonreducible inguinal hernia
Contents: Fluid, fat bowel ovary or other abdominal structures

Other soft tissue tumors benign (like lipomas) or malignat (like sarcomas) in a very young girl are rare but must be considered in any case of a solid mass. In some cases necrosis in a tumor can mimick a cystic lesion.
For more examples of inguinal hernias visit http://www.ultrasoundcases.info

Case References

Narci A, Korkmaz M, Albayrak R, Sözübir S, Güvenç BH, Köken R, Demir T, Dogru O. Preoperative sonography of nonreducible inguinal masses in girls.J Clin Ultrasound. 2008 May 27;36(7):409-412.

Huang CS, Luo CC, Chao HC, Chu SM, Yu YJ, Yen JB. The presentation of asymptomatic palpable movable mass in female inguinal hernia.Eur J Pediatr. 2003 Jul;162(7-8):493-5.

Follow Up The patient was operated and the diagnosis was confirmed

Other contents by this AuthorOther Cases in This Category

Musculoskeletal >> Superficial

Retained foreign body in the soft tissues of the forehead
Young female involved in a car accident about a month ago. Her head had crashed through the windshield. She now presents with painful swelling along her left lateral forehead.

Abdominal wall hemangioma
A month old neonate presented with anterior abdominal mass and was referred for an ultrasound.

Left supraumbilical hernia
A 50 year old obese woman with history of multiple abdominal surgeries reports a left abdominal wall swelling of one month duration. This was directly superior to a midline abdominal incision. ...

Retained foreign body in the hand
A woman presents with history of recurrent abscess formation and pain in right hand. She had a history of glass injury two months ago.

Necrotizing infection in the soft tissues of right ankle
A diabetic patient presented with redness and swelling around the right ankle. He also had a necrotic ulcer along the medial aspect of the right ankle. A clinical diagnosis of cellulitis was made ...

Infective inguinal lymphadenitis
A 35-year-old man presents with a mass in the right inguinal area. Multiple lymph nodes could be palpated clinically. An ultrasound of the right inguinal region was performed.

Left cheek hemangioma
A 17-year-old boy presented with a swelling / asymmetry of his left cheek since birth. The swelling increased when he leaned forward and when he lay on that side & reduced when he was erect. On ...

Foreign body: glass piece in the right foot
An ultrasound evaluation of the foot was performed following patient complaints of stepping on broken glass.

Hydatid Cyst of the Groin and Thigh
A 60-year old male patient presented with a large non-tender palpable mass located in the groin and the anterior compartment of his right thigh. An ultrasound of the thigh and of the abdomen was ...

Abscess in the anterior triangle of the neck
A 3-year-old girl presents with a painful lump in the left upper neck, fever and elevated WBC counts. An ultrasound of the neck was performed.

Inguinal hernia
A middle-aged man presents with a history of a bulge in the right inguinal area while coughing. An ultrasound of the right inguinal region was performed.

Glomus tumor under the nail of the thumb
14 year old female patient with pain in the thumb during compression of the nail

Enlarged thymus in the neonate
An ultrasound of the chest was done in this one-month-old baby for suspicious upper lobe consolidation.

Gluteal muscle hematoma in a patient with hemophilia
A young male, with history of hemophilia A, presented with sudden onset pain in the left gluteal region of 2 days duration. He is afebrile; there is no history of trauma. Physical examination ...

Bilateral postoperative rectus sheath hematoma
This is the scan in a 70-year-old woman with a right painful lump. She is status post hernia repair, performed a year ago. A focused anterior abdominal wall scan was performed.