Ovarian Hernia

This 2-month-old infant was brought to her physician with a 2-week history of intermittent swelling in the right distal inguinal and upper labial area (A). A palpable solid, nonreducible lump was visualized ultrasonographically as an oval, hypoechoic mass and identified as a herniated ovary (B). The hernia was repaired surgically, and the ovary remained intact.

Inguinal hernia, which occurs in fewer than 3% of infants, results when the proximal portion of the processus vaginalis peritonei fails to close. This condition is particularly common among premature infants. Infants with chronic lung disease, ascites, Ehlers-Danlos syndrome, or multiple congenital abnormalities of the pelvis and perineum are also at increased risk.

About 10% of all childhood inguinal hernias occur in girls, and the ovary is the organ most likely to herniate. It may sometimes strangulate and can be mistaken for inflamed lymph nodes, which may delay treatment (ie, surgical repair of the hernia and removal of the ovary if it is infarcted). Ultrasonographic examination may be helpful in assessing an inguinal or scrotal mass in patients of all ages.