Complex inguinal herniation containing a gravid uterus in a bitch – successful surgery and neonatal survival: a case report

BACKGROUND: Inguinal herniation containing a gravid uterus, also referred to as inguinal gravid hysterocele (IGH), is an uncommon clinical condition in dogs characterized by protrusion of the pregnant uterus through the inguinal canal. Only a few cases have been documented, and most were diagnosed in early gestation or following complications such as fetal death. To our knowledge, reports of IGH diagnosed close to term and successfully managed surgically, resulting in live offspring, are limited. CASE PRESENTATION: A 7-year-old, 16 kg, intact mixed-breed female dog presented with a large, non-painful inguinal mass. Diagnostic imaging revealed a left-sided inguinal hernia containing the uterus with two viable fetuses, intestinal loops, and the spleen. Ultrasonographic biometry suggested day 55 of gestation, consistent with advanced pregnancy. Physical examination and hematological and biochemical parameters were within reference ranges. Based on stable clinical findings and fetal viability assessment, a cesarean section combined with herniorrhaphy and simultaneous ovariohysterectomy was scheduled two days later. Both fetuses were delivered alive and initially showed good vitality. Postoperative recovery of the dam was uneventful, with no recurrence of herniation. One neonate died at 14 days postpartum, whereas the second survived and was successfully weaned. CONCLUSIONS: This case highlights the importance of thorough diagnostic evaluation and strategic surgical planning in managing IGH. This represents one of the few reported cases of IGH diagnosed at a late stage of gestation and managed at term without prior surgical correction, demonstrating that favorable maternal and neonatal outcomes are achievable with timely intervention.