Clinical analysis of ovarian hernia: report of 1 case / 中国实用妇科与产科杂志

OBJECTIVE: To explore the clinical characteristics,diagnosis,treatment,and prognosis of ovarian hernia.METHODS: The clinical data of 1 case of ovarian hernia admitted to Affiliated Shengjing Hospital,China Medical University,from 2018-07-18 were analyzed,and the related literatures at home and abroad were analyzed and summarized.RESULTS: The patient was 30 years old and visited hospital with the chief complaints of“1 d of vulva pain after assisted reproduction with 4 h of aggravation”.Ultrasonography showed that a 5.2 cm×3.6 cm×3.5 cm mass was seen in the left pubic mound,which was considered to be the vulva neoplasm. The pain was not significantly alleviated after the vaginal mass puncture treatment in the assisted reproductive department.MRI examination suggested ovarian hernia.High ligation repair of inguinal hernia and ovary repair were performed in emergency. Ovaries were successfully retained during the operation.A total of 6 cases have been reported by searching relevant literatures at home and abroad. The disease is often manifested as conscious inguinal mass,lower abdominal pain or asymptomatic.The treatment method is mainly surgery.For young women,early diagnosis and treatment should be made as soon as possible to preserve the ovary.CONCLUSION: Early diagnosis and treatment based on clinical symptoms is recommended to avoid misdiagnosis for young women with reproductive function.A multimodal and multidisciplinary approach is recommended to safely and effectively preserve ovarian function.

Aneurisma de arteria testicular: reporte de un caso y revisión de la literatura / Testicular artery aneurysm: case report and review of the literature

Resumen: Introducción: El aneurisma de la arteria testicular es poco frecuente; el término se describe como la dilatación de cualquier vaso sanguíneo en el cuerpo. Caso clínico: Se presenta el caso de un paciente de 15 años con un aneurisma de la arteria testicular izquierda sin ningún antecedente de importancia familiar ni personal, quien se presentó a consulta por aumento de volumen en la región inguinal de larga evolución, acompañado de dolor esporádico y sin más síntomas. Se diagnosticó hernia inguinal y se procedió a cirugía. El diagnóstico se realizó de manera posoperatoria por medio de estudio histopatológico. En este caso, se destaca la presentación de un aneurisma verdadero de la arteria testicular y el resultado después del tratamiento quirúrgico definitivo. Conclusiones: La etiología del aneurisma y del pseudoaneurisma reportada en la literatura se describe posterior a un traumatismo testicular, y en pocos casos de origen congénito. Las manifestaciones clínicas pueden ser dolor y una masa inguinal, y muchas de las veces pueden confundirse con hernias inguinales o ser una patología agregada, por lo que el abordaje de los pacientes con patología inguinal o testicular debe ser protocolizado e incluir el aneurisma dentro de los diagnósticos diferenciales.

Abstract: Background: Aneurysm of the testicular artery is a rare entity; the term is described as the dilation of any blood vessel in the body. Case report: An 18-year-old patient with a left testicular artery aneurysm, with no family or personal history of medical importance, presented for consultation due to a volume increase of long evolution in the inguinal region, accompanied by sporadic pain with no other symptoms. The testicular artery aneurysm was not detectable preoperatively by ultrasound, which only reported data compatible with left inguinal hernia and varicocele. The diagnosis was made postoperatively by a histopathological study. This case highlights the presentation of a true aneurysm of the testicular artery and the result after definitive surgical treatment. Conclusions: The etiology of the aneurysm and pseudoaneurysm reported in the literature is described after a testicular trauma and, a few cases of congenital origin. The clinical manifestations are pain and an inguinal mass, which can be frequently confused with inguinal hernias or an aggregated pathology. Therefore, the approach of patients with inguinal or testicular pathology should be protocolized and include aneurysm within the differential diagnoses.

A Case Report of Isolated Inguinal Tuberculous Lymphadenitis

PURPOSE: Tuberculous lymphadenitis constitutes about 30% of all types of extrapulmonary tuberculosis. Cervical lymphadenitis is the commonest form (70%), followed by axillary and inguinal. But inguinal tuberculous lymphadenitis is rare form. Especially isolated inguinal tuberculous lymphadenitis was seldom reported. In Korea, that case was not reported. This case emphasizes the need for awareness of tuberculosis as a possible cause of isolated inguinal adenitis. METHODS: We experienced one case of isolated inguinal tuberculous lymphadenitis. We analyzed clinical features, preoperative assessments and method of treatments. RESULTS: A 37-year-old female patient presented with a painless swelling in the left inguinal region of 12 month's duration. There was no history of urethral discharge, dysuria, genital sores, unprotected sexual contacts or trauma. Examination revealed enlarged left inguinal lymph nodes, 2 x 1 cm, non-tender and firm mass. The external iliac, popliteal, right inguinal and other groups of lymph nodes were normal. Serologic tests, urinary tests and chest radiologic test were normal. The excision of mass was performed under the general anesthesia. A excisional biopsy showed chronic granulomatous inflammation with caseous necrosis, consistent with tuberculosis. After excision, the primary repair was done and completely healed on postoperative 25 days. CONCLUSION: The isolated inguinal tuberculous lymphadenitis was rare form of inguinal suppurative mass. Although medical management is the principal mode of therapy of tuberculous adenitis and surgery is rarely necessary, we didn't consider the possibility of tuberculous lymphadenitis in our case. A high index of suspicion is essential for a diagnosis of isolated inguinal tuberculous lymphadenitis. Our case emphasizes this importance and illustrates the need for awareness of tuberculosis as a possible cause of isolated inguinal adenitis.

A Case Report of Isolated Inguinal Tuberculous Lymphadenitis

PURPOSE: Tuberculous lymphadenitis constitutes about 30% of all types of extrapulmonary tuberculosis. Cervical lymphadenitis is the commonest form (70%), followed by axillary and inguinal. But inguinal tuberculous lymphadenitis is rare form. Especially isolated inguinal tuberculous lymphadenitis was seldom reported. In Korea, that case was not reported. This case emphasizes the need for awareness of tuberculosis as a possible cause of isolated inguinal adenitis. METHODS: We experienced one case of isolated inguinal tuberculous lymphadenitis. We analyzed clinical features, preoperative assessments and method of treatments. RESULTS: A 37-year-old female patient presented with a painless swelling in the left inguinal region of 12 month's duration. There was no history of urethral discharge, dysuria, genital sores, unprotected sexual contacts or trauma. Examination revealed enlarged left inguinal lymph nodes, 2 x 1 cm, non-tender and firm mass. The external iliac, popliteal, right inguinal and other groups of lymph nodes were normal. Serologic tests, urinary tests and chest radiologic test were normal. The excision of mass was performed under the general anesthesia. A excisional biopsy showed chronic granulomatous inflammation with caseous necrosis, consistent with tuberculosis. After excision, the primary repair was done and completely healed on postoperative 25 days. CONCLUSION: The isolated inguinal tuberculous lymphadenitis was rare form of inguinal suppurative mass. Although medical management is the principal mode of therapy of tuberculous adenitis and surgery is rarely necessary, we didn't consider the possibility of tuberculous lymphadenitis in our case. A high index of suspicion is essential for a diagnosis of isolated inguinal tuberculous lymphadenitis. Our case emphasizes this importance and illustrates the need for awareness of tuberculosis as a possible cause of isolated inguinal adenitis.

A Case of Meconium Hydrocele Presenting as Inguinal Mass in a Female Newborn

Meconium peritonitis results from in-utero perforation of gastrointestinal tract, with subsequent leakage of meconium into the peritoneal cavity. Patent processus vaginalis of male or female fetus may lead to migration of meconium into inguinal canal, and these infants may present meconium filled hydroceles at birth. The predominance of meconium hydrocele in the male infant may be due to the obliteration of processus vaginalis occuring later than in the female fetus. We report a rare case of bilateral meconium hydrocele in the female newborn, which mimic clinical symptoms and ultrasonographic findings of incarcerated hernia.

Endometriosis inguinal: evidencia de enfermedad agresiva: Informe de un caso

Se presenta caso de una mujer de 30 años que presenta dolor crónico en el cuadrante inferior derecho de la pelvis, irradiado a la porción anterior del muslo derecho. Además, la paciente refiere constipación, dispareunia y sensación de masa dolorosa en dicha región, la cual se incrementó en tamaño y se hizo más dolorosa durante la menstruación. La laparoscopia diagnóstica, seguida de laparotomía reveló: endometriosis estadio IV, con implantes a nivel intestinal. Se realizó excisión extensa de lesiones de endometriosis, resección-anastomosis del colon rectosigmoides, además de excisión de masa inguinal, con confirmación histopatológica de nódulo endometriósico inguinal.

A 30 year old woman experienced chronic right sided pelvic pain, radiated to her right thigh anteriorly, constipation, dyspareunia and right inguinal tender mass, which increased in size and became painful in association with her menstruation. A diagnostic laparoscopy followed by laparotomy revealed stage IV endometriosis, with bowel involvement. Extensive excision of endometriosis, rectosigmoid colon resection-anastomosis and excision of inguinal mass were performed, with histopathology confirmation of inguinal endometriotic nodule.