Torsion of the ovary in an incarcerated inguinal hernia

A 2.5-month-old girl with a left-sided, painful inguinal swelling for the last 2 days was brought to the emergency department. After physical examination and radiological evaluation, the diagnosis of incarcerated inguinal hernia of the ovary was made. Because of the long-standing history, she was taken to the operation room without an attempt for manual reduction. Perioperatively, the torsion of the ovary with distal fallopian tube within the indirect hernia sac was seen. As untwisting of the ovary has resulted in no change in the color, oophorectomy before hernia repair was performed.The majority of the painful inguinal swellings in the infancy are related to incarcerated hernia. The treatment option varies from manual reduction to surgical intervention, depending on the duration from beginning of swelling to the time the exact diagnosis was made. Even though the presence of short-term history and the lack of peritoneal irritation findings are indications for a manual reduction, the suspicion of an ovarian torsion should be raised for ovaries within the incarcerated inguinal hernia, and ovarian viability should be considered before an attempt of manual reduction.