Complicated inguinal hernia with a twisted ovary. A unique case in pediatrics

Abstract

Introduction: inguinal hernia is defined as the protrusion of abdominal viscera, although other times of the ovary and omentum, into the peritoneal sac, complications are frequent, especially in children under 6 months of age.

Objective: to describe the treatment applied to a complicated inguinal hernia with a twisted ovary inside by the surgery department of the Pedro Agustín Pérez Provincial Pediatric Hospital.

Case presentation: 4-month-old female infant, who came to the emergency room with a history of increased volume in the right inguinal region for 2 days, presented phlogistic signs of inflammation and irritability; The physical examination revealed a painful increase in volume upon superficial palpation in the right inguinal region, and few inflammatory phlogistic signs in the region of the labia majora. A complicated right inguinal hernia was diagnosed and a soft tissue ultrasound was performed coinciding with the initial clinical diagnosis. The intraoperative findings were: blackish ovary with areas of necrosis, maceration, increase in volume and 2 ovarian rotations counterclockwise. During the operation, right oophorectomy and inguinal herniorrhaphy were performed. The postoperative evolution was satisfactory; he was discharged on the fourth day.

Conclusions: the diagnosis of inguinal hernias is clinical. Ultrasound is widely accepted as the best modality to evaluate abnormality of the inguinal area, especially in children. The urgency with which this entity is treated is important to obtain satisfactory results and evolution