Occult inguinal hernia in the female

Inguinal hernioplasty was performed in a series of 14 female patients with occult inguinal hernias over a period of five years. During this time 194 herniorrhaphies were performed and thus the incidence of repair for occult hernia was 8%. These patients represent a definite syndrome which has not been sufficiently documented in the surgical literature. The condition is defined and the anatomic pathology documented photographically. The mean age in this series was 20 years with a range of 15-45 years. Thirteen of the 14 cases were followed a mean of 10 months postoperatively. Ten of these were considered excellent results and were symptom-free. The remaining three cases were judged as good results but objective evaluation was less conclusive. There have been no recurrences. The anatomic basis for this syndrome has been documented by others. The absence of an impulse on clinical examination is explained on the basis of size of the hernias and the difference in the anatomy between males and females. Occult inguinal hernia in the female is clinically recognizable on the basis of intermittency, character, and localization of pain and after the exclusion of other pathologic conditions. This syndrome should be entertained in the differential diagnosis of lower abdominal pain in the female. Hernioplasty is safe and effective therapy and returns the patient to normal activity.