A rare case of adult ovarian inguinal hernia with an associated pelvic ectopic kidney

Ovarian inguinal hernia is an uncommon condition, particularly in adult females, and poses significant diagnostic challenges. This report details the case of a 40-year-old female presenting with a left-sided ovarian hernia, highlighting the clinical presentation, imaging findings, surgical management, and postoperative outcomes. A 40-year-old woman presented with a nonreducible, tender swelling in the left groin associated with intermittent pain. Laboratory tests were normal, and the patient was afebrile. Ultrasound revealed a hernia sac in the left inguinal region containing a structure consistent with the ovary, confirmed by the presence of follicles and normal vascularity on Doppler imaging. A pelvic ectopic kidney was also identified. A subsequent CT scan provided detailed anatomical visualization, confirming the diagnosis of ovarian inguinal hernia. Surgical exploration revealed the left ovary and fallopian tube within the hernia sac, both of which were normal in appearance. The structures were carefully returned to the pelvic cavity, and the defect in the inguinal canal was repaired using nonabsorbable sutures. Ovarian inguinal hernias are rare in adults, often associated with anatomical variations, such as ectopic pelvic kidneys in this case. Accurate diagnosis relies heavily on imaging modalities, which guide the surgical approach and help rule out complications like torsion. Early surgical intervention is imperative to prevent potential morbidity and preserve ovarian function. This case underscores the diagnostic and therapeutic importance of imaging and surgical management in ovarian inguinal hernias in adults. Clinicians must consider this rare entity when evaluating nonreducible groin masses to ensure timely and effective treatment.