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Scott R. Steele, MD; Matthew J. Martin, MD; Philip S. Mullenix, MD; Michael A. Bidus, MD; Kenneth S. Azarow, MD
From the Department of Surgery, Madigan Army Medical Center, Fort Lewis, Wash (Drs Steele, Martin, Mullenix, and Azarow), and the Department of Obstetrics and Gynecology, Bremerton Naval Hospital, Bremerton, Wash (Dr Bidus). Dr Steele is now with the Department of General Surgery, Darnall Army Community Hospital, Fort Hood, Tex.

Arch Surg. 2004;139:797.

INTRODUCTION
An 18-year-old woman presented with a 2-year history of intermittent right groin pain and swelling. Physical examination demonstrated a 2 x 4-cm soft, nontender, nonreducible mass in the right inguinal region. She had normal breast and secondary sexual development. Ultrasonography of the right groin demonstrated a tubular structure, which was thought to be small bowel. An exploration of the right groin showed the fallopian tube and ovary in a hernia sac protruding through a defect in the external oblique aponeurosis (Figure 1). The structures were lying in the subcutaneous tissue and not attached to the uterus (Figure 2).

View larger version (53K): [in this window] [in a new window] Figure 1.

View larger version (30K): [in this window] [in a new window] Figure 2.

When Identifying This Anatomy, What Other Organ System(s) Need to Be Evaluated for Concomitant Abnormalities?

Jump to Section  • Top  • Introduction  • When identifying this anatomy,...

A. Renal

B. Musculoskeletal

C. Gynecological

D. All of the above

Answer

SECTION EDITOR: GRACE S. ROZYCKI, MD

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Image of the Month—Diagnosis
Arch Surg. 2004;139(7):798.
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