Document Detail

Inguinal ovary in adult women-case report and literature review.
Jump to Full Text
MedLine Citation:
PMID:  24255844     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
This paper describes a rare finding of an inguinal ovary in an adult woman who presented with pelvic pain. Inguinal ovary may occur if the gubernaculum fails to attach to the uterus or if the canal of Nuck remains open during fetal development.
Authors:
Mette L Josefsson; Surajit Mitra; Sanjay Gupta
Related Documents :
8471784 - Case studies in binaural interference: converging evidence from behavioral and electrop...
20685164 - Immediate versus delayed self-reporting of symptoms and side effects during chemotherap...
11343604 - Excessive yawning and ssri therapy.
23955424 - Markers for nutrition studies: review of criteria for the evaluation of markers.
21654964 - Washing machine injuries of the upper extremity: case reports with a review of the lite...
6872964 - Mechanical lithotripsy through the intact papilla of vater.
Publication Detail:
Type:  Journal Article     Date:  2013-10-17
Journal Detail:
Title:  SpringerPlus     Volume:  2     ISSN:  2193-1801     ISO Abbreviation:  Springerplus     Publication Date:  2013  
Date Detail:
Created Date:  2013-11-22     Completed Date:  2013-11-22     Revised Date:  2014-01-24    
Medline Journal Info:
Nlm Unique ID:  101597967     Medline TA:  Springerplus     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  545     Citation Subset:  -    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Full Text
Journal Information
Journal ID (nlm-ta): Springerplus
Journal ID (iso-abbrev): Springerplus
ISSN: 2193-1801
Publisher: Springer International Publishing, Cham
Article Information
Download PDF
© Josefsson et al.; licensee Springer. 2013
open-access:
Received Day: 23 Month: 9 Year: 2013
Accepted Day: 7 Month: 10 Year: 2013
Electronic publication date: Day: 17 Month: 10 Year: 2013
pmc-release publication date: Day: 17 Month: 10 Year: 2013
collection publication date: Year: 2013
Volume: 2E-location ID: 545
PubMed Id: 24255844
ID: 3825092
Publisher Id: 622
DOI: 10.1186/2193-1801-2-545

Inguinal ovary in adult women-case report and literature review
Mette L JosefssonAff1 Address: m.josefsson@doctors.org.uk
Surajit MitraAff1 Address: surajit.mitra@nhs.net
Sanjay GuptaAff2 Address: sanjay.gupta@nhs.net
Department of Obstetrics and Gynaecology, Lister Hospital, Coreys Mill Lane, Stevenage, Hertfordshire, SG1 4AB UK
Department of General Surgery, Lister Hospital, Coreys Mill Lane, Stevenage, Hertfordshire, SG1 4AB UK

Introduction

Ovary within the inguinal canal is occasionally seen in infants, but is rare in adult women. This paper describes a woman with an inguinal ovary who presented with pelvic pain. We review the literature and discuss its embryological background.


Case report

A 33 year-old-woman presented with pelvic pain on a background of longstanding left sided iliac fossa pain, which was exaggerated by constipation and movement. Past medical history included depression, scarred left kidney from recurrent urinary tract infections and surgery for urethral diverticulum. Obstetric history included two vaginal deliveries following subfertility treatment. Ultrasound scan demonstrated an unremarkable retroverted uterus and normal renal tract. The right ovary appeared normal however left ovary was not identified. Diagnostic laparoscopy revealed the left ovary herniating through the left internal inguinal ring (Figure 1a-b). The left ovarian and round ligaments were absent and only a small left fallopian tube was seen (Additional file 1: Figure S1). Uterus, and right tube, ovary and round ligament appeared normal. She later underwent laparoscopic mobilization of the ovary and mesh repair of the inguinal canal jointly with the general surgeons (Additional file 2: Figure S2). She recovered well and was discharged home two days later.

Comment

A literature search revealed twelve case reports in adults. The majority presented with a palpable groin mass and they were diagnosed at time of surgery for suspected bowel hernia (Tagliaabue [2011]; Machado & Machado [2011]; Mandel et al. [2010]; Alzaraa [2011]). One woman presented with pelvic pain and was found on laparoscopy to have a rudimentary uterine horn and ovary herniating through the inguinal canal (Al Omari et al. [2011]). Coexisting mullerian and renal malformations have been described (Alzaraa [2011]; Al Omari et al. [2011]).

Male and female reproductive systems share common steps in early development. Understanding this helps to comprehend the causes of inguinal ovary. The gonads develop from mesothelium on the urogenital ridge. Initially in both male and female, the gonads are situated posterior in the abdominal cavity. After sex differentiation both ovaries and testes descend, but to varying extent. The testes descend to the scrotum via the gubernaculums, a caudal remnant of the mesonephric duct that passes through the abdominal wall to the labioscrotal swelling. As the embryo grows the gubernaculums remains the same size causing the testes to be situated progressively lower down. By the eight month the testes have reached the scrotum and by birth the processus vaginalis at the internal inguinal ring closes.

Contrary to the testes, the ovary descends to a lesser extent because the gubernaculums adheres to the uterus, thus preventing movement. If the gubernaculum fails to attach, the ovary may descend through the inguinal canal. The canal of Nuck is a pouch of peritoneum, analogous to the processus vaginalis in males, which follows the round ligament from the ovary to the labia via the inguinal canal. This canal closes within the first year of life. If it fails to close a hernia may form.


Conclusion

This paper describes a rare case of inguinal ovary in a woman who presented with pelvic pain. An inguinal ovary may occur if the gubernaculum fails to attach to the uterus in fetal life or if the canal of Nuck remains open after birth.


Consent

Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.



Notes

Competing interests

Mette Josefsson, Surajit Mitra, and Sanjay Gupta declare that they have no conflict of interest.

Authors’ contributions

Patient was under the care of SM. The idea and planning was done by SM. SG did the mesh repair. MLJ did the literature search and writing of the draft. All authors contributed to revising the paper. All authors read and approved the final manuscript.

Acknowledgement

We acknowledge the patient who the case report is based on. The patient did not receive any financial compensation.


References
Al Omari W,Hashimi H,Al Bassam MK. Inguinal uterus, fallopian tube, and ovary associated with adult Mayer-Rokitansky-Kuster-Hauser syndromeFertil sterilYear: 201195111910.1016/j.fertnstert.2010.09.06521036352
Alzaraa A. Unusual contents of the femoral herniaObstet gynaecolYear: 20112011717924
Machado NO,Machado NN. Unusual contents of inguinal hernia sac. An approach to managementSurg SciYear: 2011232232510.4236/ss.2011.26068
Mandel DC,Beste T,Hope W. Hernia uterine inguinale: an uncommon cause of pelvic pain in the adult female patientJ mimim invas gynYear: 20101778779010.1016/j.jmig.2010.06.008
Tagliaabue F. Indirect inguinal hernia containing fallopian tube, ovary and ovarian cyst in adult womanChirurigiaYear: 2011249597

Figures

[Figure ID: Fig1]
Figure 1 

a and b, Laparoscopic images of left ovary herniating through the left internal inguinal ring.



Article Categories:
  • Short Report


Previous Document:  A novel antifungal protein of Bacillus subtilis B25.
Next Document:  Adoption of radio-frequency identification to establish traceability in Taiwanese eel exported to th...