Laparoscopic approach in an incarcerated femoral hernia, with the ipsilateral fallopian tube as a single content

Abstract

The right fallopian tube as a single content of an incarcerated femoral hernia is an uncommon condition. Due to its extreme rarity, preoperative misdiagnosis is frequent.

Femoral hernias are more frequent among women. The strangulation rate is higher than in the other groin hernias. Thus, femoral hernias are usually operated on and diagnosed in an emergency setting which leads to higher postoperative morbidity and mortality.

The main aim is to verify the vitality of the contents of the hernia sac. In the absence of ischaemic signs, the contents can be safely reduced back into the abdominal cavity. Otherwise, resection is inevitable. The authors report the case of a 20-year-old patient presenting an incarcerated femoral hernia containing the ipsilateral fallopian tube. At laparoscopic exploration, the fallopian tube was seen to be contained within the sac, without the ovary which was in the abdominal cavity. After checking out the vitality of the fallopian tube, it was reduced back into the pelvis. A resection of the hernia sac with a suture of the neck was performed. Postoperative recovery was uneventful and the patient was discharged on the second day following surgery. The patient was informed of the risk of an ectopic pregnancy that could prove fatal due to incarceration of the fallopian tube. To our knowledge, this is the sixth case to be reported in the literature, and the first time a laparoscopic approach has been used in such a case. Diagnostic and therapeutic aspects of this rare condition will be discussed, along with a review of previous reported cases.