Ultrasound features are consistent with a left canal of Nuck hernia transmitting the left ovary. Canal of Nuck hernias are rare and can transmit the ovary in females. It has a high risk of vascular compromise and torsion of the herniated ovary.

Early signs of vascular compromise to the ovary or partial torsion include thickening of the ovarian pedicle and absent diastolic flow on Doppler study. Correction of the Doppler steer angel along the vascular stalk of the ovary and repeated sampling is important to exclude false-positive results. It is also important to examine the other ovary and confirm its location. 

It is important to examine the other side in all cases of inguinal hernia. In pediatrics, the examination should be done while crying, on standing (lifted by the parent) or with the aid of abdominal compression so as to exclude hernia on the other side, so as to be done at the same surgical setting. Even small hernial sac should be searched for. 

Other common abnormalities of the canal of Nuck include bowel hernia, hydrocele and endometriosis.

Inguinal lymph nodes are normal in pediatrics and usual finding and often confused with inguinal hernia and undescended testis in males.