Presentation
Left inguinal swelling.
Patient Data
Left inguinal hernial sac containing the left ovary and its pedicle as well as the omentum with surrounding free fluid, communicating with the peritoneal cavity through a defect of the canal of Nuck. The ovary within the hernial sac contains small follicles with normal vascular supply on color Doppler.
Case Discussion
Canal of Nuck hernias are rare and occur in female children. They are due to failure of complete obliteration of the canal of Nuck with a connection to the peritoneal cavity and transmitted intra-abdominal contents (e.g. bowel, omentum, fluid, ovary, Fallopian tube and/or urinary bladder).
The risk for ovarian torsion is increased with incarceration due to blockage of normal venous and lymphatic return from the ovary herniated into the canal of Nuck. Once diagnosed, surgery is required due to the high rate of ovarian torsion.
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