RESUMO
Concurrent direct and indirect inguinal, femoral, and obturator hernias are rare. This case report describes a rare case treated using the laparoscopic approach. A 68-year-old female patient presented with a moving left inguinal lump and pain. Physical examination and abdominal computed tomography scan revealed the coexistence of a left inguinal hernia or Nuck canal hydrocele and a left femoral hernia. The patient underwent laparoscopic transabdominal preperitoneal repair, and all four orifices were covered with one mesh. The patient was discharged on the second postoperative day without any complications. The concurrent presence of four hernias on the same side is rare and has not been previously reported. The laparoscopic approach is useful in such cases because it allows visualization of multiple hernia orifices from the intra-abdominal cavity.
Assuntos
Hérnia Femoral , Hérnia Inguinal , Hérnia do Obturador , Herniorrafia , Laparoscopia , Humanos , Feminino , Idoso , Hérnia do Obturador/cirurgia , Hérnia do Obturador/complicações , Hérnia do Obturador/diagnóstico por imagem , Hérnia Femoral/cirurgia , Hérnia Femoral/complicações , Hérnia Femoral/diagnóstico , Herniorrafia/métodos , Hérnia Inguinal/cirurgia , Hérnia Inguinal/complicações , Telas CirúrgicasRESUMO
This case report involves an elderly woman who presented with a 3-day history of a tender groin swelling on her right side. Her admission bloods were fairly unremarkable, but a preoperative ultrasound impressively confirmed a femoral hernia containing the appendix (De Garengeot hernia) and she underwent emergency laparoscopic hernioplasty with a prosthetic mesh and appendicectomy. The procedure found an incarcerated hernia with a strangulated tip of the appendix that unexpectedly separated upon gentle manipulation and histopathology revealed appendiceal inflammation. There were no complications with the patient's recovery and she was discharged 2 days after surgery.
Assuntos
Apêndice , Hérnia Femoral , Laparoscopia , Feminino , Humanos , Idoso , Apêndice/cirurgia , Apendicectomia/métodos , Hérnia Femoral/diagnóstico , Hérnia Femoral/diagnóstico por imagem , Herniorrafia/métodosRESUMO
PURPOSE: Femoral hernia (FH) is a rare and often misdiagnosed pathology in pediatric population. The aim of our study was to describe the experience of a Tertiary Center in children with FH, underlying diagnostic and surgical details that could improve its management. METHODS: A retrospective study of pediatric patients who underwent FH repair from January 2010 to June 2023 at our Institution was performed. RESULTS: In the analyzed period, 31 patients underwent surgical procedure for FH at our institution, of whom 16 (51.6%) were female. The mean age at time of surgery was 5.8 years (range 0.5-17.1 years). The rate of pre-operative misdiagnosis was 35.5% and open approach was adopted in all cases (16.1% with mesh application). Only two patients (6.4%) experienced surgical complications: one recurrence (repaired six months later) and one post-operative hematoma (treated successfully with conservative method). CONCLUSION: Due to the high rate of misdiagnosis, the variety of surgical approaches proposed, and the potential for intraoperative complications, FH poses a challenge for pediatric surgeons and urologists, as confirmed by the literature. It is essential to underline the importance of a proper clinical examination in order to correctly diagnose FH, make the best surgical plan for the patient and prevent post-operative complications.
Assuntos
Hérnia Femoral , Hérnia Inguinal , Laparoscopia , Humanos , Criança , Feminino , Lactente , Pré-Escolar , Adolescente , Masculino , Hérnia Femoral/diagnóstico , Hérnia Femoral/cirurgia , Estudos Retrospectivos , Laparoscopia/métodos , Herniorrafia/efeitos adversos , Herniorrafia/métodos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Hérnia Inguinal/cirurgia , Telas Cirúrgicas , RecidivaRESUMO
INTRODUCTION: Guidelines recommend MIS repairs for females with inguinal hernias, despite limited evidence. We investigated rates of femoral hernias intraoperatively noted during MIS and Lichtenstein repairs in females. METHODS: ACHQC was queried for adult females undergoing inguinal hernia repair between January 2014-November 2022. Outcomes included identified femoral hernia and size, hernia recurrence, quality of life, and sex-based recurrence. RESULTS: 1357 and 316 females underwent MIS and Lichtenstein inguinal repair respectively. Femoral hernias were identified more frequently in MIS than open repairs (27%vs12%; (p â< â0.001). Most femoral hernias in MIS (61%) and Lichtenstein repairs (62%) were <1.5 âcm(p â< â0.001). Identification rates of femoral hernias >3 âcm were 1% overall(p â= â0.09). Surgeon and patient-reported recurrences were similar between approaches at 1-5-years for females(p â> â0.05 for all) and similar between sexes(p â> â0.05). CONCLUSION: Most incidental femoral hernias are small and both repair approaches demonstrated similar outcomes. The recommendation for MIS inguinal hernia repairs in females is potentially overstated.
Assuntos
Hérnia Femoral , Hérnia Inguinal , Laparoscopia , Adulto , Feminino , Humanos , Hérnia Inguinal/diagnóstico , Hérnia Inguinal/cirurgia , Hérnia Femoral/diagnóstico , Hérnia Femoral/cirurgia , Qualidade de Vida , Recidiva , Herniorrafia , Telas CirúrgicasRESUMO
A 46-year-old female presented to the emergency room with complaints of right groin pain. A palpable mass was found inferior to the right inguinal ligament. Computed tomography showed evidence of a viscera-containing hernia sac within the femoral canal. The patient was taken to the operating room for exploration of the hernia where a well-perfused right fallopian tube and right ovary were identified within the sac. These contents were reduced, and the facial defect repaired primarily. The patient was discharged and has since been seen in clinic with no residual pain or recurrence of her hernia. Femoral hernias containing gynecological structures pose unique management and only anecdotal evidence exists to guide decision making. Prompt intervention with primary repair resulted in a favorable operative outcome in this case of a femoral hernia containing adnexal structures.
Assuntos
Hérnia Femoral , Hérnia Inguinal , Humanos , Feminino , Pessoa de Meia-Idade , Ovário , Tubas Uterinas/cirurgia , Virilha/cirurgia , Hérnia Inguinal/cirurgia , Hérnia Femoral/diagnóstico , Hérnia Femoral/cirurgia , DorRESUMO
De Garengeot hernia is a rare type of femoral hernia that presents with appendicitis. This clinical condition that usually occurs in the 7th decade, mostly in women, requires urgent surgery. Here, we present a 73-year-old patient with acute appendicitis within the femoral hernia sac.
Assuntos
Apendicite , Hérnia Femoral , Doença Aguda , Idoso , Apendicectomia , Apendicite/diagnóstico , Apendicite/diagnóstico por imagem , Feminino , Hérnia Femoral/diagnóstico , Hérnia Femoral/diagnóstico por imagem , Humanos , Extremidade InferiorRESUMO
A De Garengeot hernia is a femoral hernia containing the vermiform appendix. This extremely rare hernia is associated with appendicitis and the risk of perforation and abscess formation. Given limited data, it poses both diagnostic and management difficulties. While management is generally surgical, questions remain about the best operative approach, indications for appendicectomy and optimum hernia repair technique. We describe a case of acute appendicitis within a De Garengeot hernia that was managed with an open appendicectomy via a Lockwood incision. This case helps to illustrate the management considerations present for this rare clinical pathology and describes a method to effectively identify the hernia and resect the appendix.
Assuntos
Apendicite , Apêndice , Hérnia Femoral , Apendicectomia/métodos , Apendicite/complicações , Apendicite/diagnóstico , Apendicite/cirurgia , Apêndice/patologia , Apêndice/cirurgia , Hérnia Femoral/complicações , Hérnia Femoral/diagnóstico , Hérnia Femoral/cirurgia , Herniorrafia , HumanosRESUMO
INTRODUCTION A De Garengeot hernia is defined by a femoral hernia containing the appendix. Acute appendicitis within a femoral hernia is an extremely rare surgical presentation and occurs in only 0.08-0.013% of cases cited in the literature and 5 to 15% of all femoral hernias. CASE PRESENTATION A 53-year-old woman presented to the emergency room of our hospital in our ward with acute onset of a right-sided inguinal swelling that occurred earlier that day after performing a heavy lift. Her examination revealed acute appendicitis contained within an incarcerated right femoral hernia. The patient underwent laparoscopic appendectomy with open femoral hernia repair. Intraoperatively, the tip of the appendix was incarcerated within the hernial sac. She was removed through the open inguinal incision after the base of the appendix has been divided laparoscopically. The final pathology showed acute inflamed appendicitis with no evidence of neoplasm. DISCUSSION Physicians should be aware of the rare extent of an unusual presentation of appendicitis such as well as surgical options for treatment. The literature does not conclude on a gold standard for the method of approach. CONCLUSION De Garengeot's hernia remains a rare and unusual surgical presentation of femoral hernia, and the complication of the case by incarceration leading to acute appendicitis provides a challenging surgical approach that should be personalized for each patient
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Apendicite/cirurgia , Apendicite/diagnóstico , Hérnia Femoral/cirurgia , Hérnia Femoral/diagnóstico , Apendicectomia/métodosRESUMO
OBJECTIVE: To study the possibility of totally extraperitoneal repair combined with diagnostic laparoscopy in the treatment of strangulated groin hernias (Laparoscopy-Assisted Totally Extraperitoneal Plasty, LATEP). MATERIAL AND METHODS: We analyzed the results of laparoscopic totally extraperitoneal hernia repair. The trocar placement technique was modified. There were 38 patients with strangulated groin hernia. The sample included 26 patients with strangulated inguinal hernia, 9 ones with strangulated femoral hernia and 3 patients with recurrent strangulated inguinal hernia. RESULTS: LATEP was attempted in 38 patients and successful in 37 (97.3%) cases. In 1 (2.6%) patient, correction of small bowel strangulation was failed and conversion to open surgery was required. In 29 patients (76.3%), correction of strangulation was performed after laparoscopy-assisted external manipulations and careful traction from abdominal cavity. In 8 (21%) cases, strangulation spontaneously regressed before laparoscopy. Laparoscopy confirmed viability of strangulated organs in 36 patients. One (2.6%) patient required bowel resection due to small intestine wall necrosis. Later, all patients underwent totally extraperitoneal repair. We were able to prevent the contact of hernia sac fluid with the implant in all cases. At the stage of preperitoneal repair, local damage to peritoneum occurred in 9 patients. Nevertheless, sealing was not required since hernia fluid was previously removed from abdominal cavity. There were no signs of implant infection and hernia recurrence within 6-14 months. CONCLUSION: Totally extraperitoneal repair combined with diagnostic laparoscopy is possible for strangulated groin hernias.
Assuntos
Hérnia Femoral , Hérnia Inguinal , Laparoscopia , Virilha/cirurgia , Hérnia Femoral/complicações , Hérnia Femoral/diagnóstico , Hérnia Femoral/cirurgia , Hérnia Inguinal/complicações , Hérnia Inguinal/diagnóstico , Hérnia Inguinal/cirurgia , Herniorrafia/efeitos adversos , Herniorrafia/métodos , Humanos , Laparoscopia/efeitos adversos , Laparoscopia/métodosRESUMO
BACKGROUND: Femoral hernias are an uncommon groin pathology among pediatric patients. Therefore, they are frequently misdiagnosed. In the present study, we review our experience with this rare surgical entity during the past 25 years. METHODS: The medical records of 19 patients who underwent 22 femoral hernia repairs between January 1994 and December 2019 were retrospectively analysed. RESULTS: Patients' age ranged from 2 to 12 years (mean age was 5. 5 years) with an approximately equal sex ratio (10 girls/9 boys). There were three bilateral cases identified separately. They were discovered and managed at different times. All the children were referred with a groin lump, but the correct pre-operative diagnosis was made in only 13 cases (59%). In the remaining cases, four were identified intraoperatively following negative exploration for a supposed inguinal hernia. The other five were found to have a femoral hernia 1 month to 12 months after ipsilateral inguinal hernia repair. All patients underwent elective surgery. The femoral canal was closed using either Lytle or McVay procedure. Recurrence occurred in only one patient 2 months after initial repair. CONCLUSION: Femoral hernias are often misdiagnosed. Pre-operative diagnosis can be obtained through careful clinical assessment. In equivocal cases, ultrasonography and laparoscopy could be useful. A correct pre-operative diagnosis will lead to suitable treatment, thus avoiding unnecessary reoperations and their related complications.
Assuntos
Hérnia Femoral , Hérnia Inguinal , Laparoscopia , Criança , Pré-Escolar , Erros de Diagnóstico , Feminino , Hérnia Femoral/diagnóstico , Hérnia Femoral/cirurgia , Hérnia Inguinal/diagnóstico , Hérnia Inguinal/cirurgia , Humanos , Masculino , Estudos RetrospectivosRESUMO
De Garengeot hernia is a rare finding of the vermiform appendix inside a femoral hernia sac. We report this occurrence in a 73-year-old woman who presented in the acute setting. There are no standardised surgical approaches and many different techniques have been described in case reports in the literature. We conducted a literature review of and found a total of 113 cases with addition of our case 114 unique cases were included for analysis. Inguinal incision was most cited (n=89). Concomitant laparotomy was needed in 13 patients, however, the association between type of incision and additional laparotomy was not significant (p>0.05). Laparoscopic surgery alone was performed in eight patients. Nine patients had hybrid surgery. The most common hernia repair was through suture technique with non-absorbable material (n=31). Mesh repair was used in 28 cases. More laparoscopic surgeries were done when the disease was diagnosed preoperatively (7/39, p<0.05).
Assuntos
Hérnia Femoral , Idoso , Feminino , Hérnia Femoral/diagnóstico , Hérnia Femoral/cirurgia , Humanos , Laparoscopia/métodosRESUMO
PURPOSE: In the paediatric population, femoral hernia (FH) represents an uncommon and often misdiagnosed pathology. This study aimed to review our experience with the management of FH in children. METHODS: Medical records were retrospectively reviewed for all patients presenting to the paediatric surgical service in Ireland over a 15-year period (2004-2019), who were operated on for FH. Collected data included demographics, preoperative diagnosis, operative details, complications and follow-up. RESULTS: During the study period, n = 26 patients (n = 18 males) underwent FH repair, with a median age at surgery 6.9 years (range 3-16 years). During the same period n = 5693 patients underwent inguinal herniotomy, resulting in a FH to inguinal hernia (IH) ratio of 1:219 and a FH incidence of 0.45% of all groin hernias. The right side was affected in n = 18 (69.2%) cases and all cases were unilateral. A correct preoperative diagnosis was established in n = 16 (61.5%) cases, n = 8 (30.8%) cases were misdiagnosed as IH and the diagnosis was equivocal in 2 cases (7.7%). All operations were performed on an elective basis. In 3 patients from the misdiagnosed group, FH was found at first operation following negative groin exploration for IH. The remaining 5 patients underwent previous groin exploration for suspected IH and represented with clinical picture of groin hernia recurrence. All patients with a correct preoperative diagnosis underwent a FH repair via an inguinal or infra-inguinal approach. The content of the hernia sac was preperitoneal fat in n = 18 cases, lymph nodes in n = 2 cases, omentum in n = 1 and an empty sac in n = 1. There were no postoperative complications or recurrences. Median follow-up time was 6 weeks (range 0-2.5 years). CONCLUSION: In the paediatric population, FH is a rare pathology and can be a challenging diagnosis. FH is commonly misdiagnosed as IH and may require more than one operation to correctly identify and treat. A high index of suspicion of FH should be maintained in patients who have a negative groin exploration for IH in the setting of a clear pre-operative diagnosis of a groin hernia. FH should also be considered in the differential diagnosis when an IH appears to recur.
Assuntos
Hérnia Femoral , Hérnia Inguinal , Adolescente , Criança , Pré-Escolar , Hérnia Femoral/diagnóstico , Hérnia Femoral/epidemiologia , Hérnia Femoral/cirurgia , Hérnia Inguinal/cirurgia , Herniorrafia , Humanos , Irlanda , Masculino , Recidiva , Estudos RetrospectivosRESUMO
PURPOSE: We sought to estimate the prevalence, incidence, and timing of surgery for elective and non-elective hernia repairs. METHODS: We performed a retrospective cohort study, abstracting data on children < 18 years from the 2005-2014 DoD Military Health System Data Repository, which includes > 3 million dependents of U.S. Armed Services members. Our primary outcome was initial hernia repair (inguinal, umbilical, ventral, or femoral), stratified by elective versus non-elective repair and by age. We calculated prevalence, incidence rate, and time from diagnosis to repair. RESULTS: 19,398 children underwent hernia repair (12,220 inguinal, 5761 umbilical, 1373 ventral, 44 femoral). Prevalence of non-elective repairs ranged from 6% (umbilical) to 22% (ventral). Incidence rates of elective repairs ranged from 0.03 [95% CI: 0.02-0.04] (femoral) to 8.92 [95% CI: 8.76-9.09] (inguinal) per 10,000 person-years, while incidence rates of non-elective repairs ranged from 0.005 [95% CI: 0.002-0.01] (femoral) to 0.68 [95% CI: 0.64-0.73] (inguinal) per 10,000 person-years. Inguinal (median = 20, interquartile range [IQR] = 0-46 days), ventral (median = 23, IQR = 5-62 days), and femoral hernias (median = 0, IQR = 0-12 days) were repaired more promptly and with less variation than umbilical hernias (median = 66, IQR = 23-422 days). CONCLUSIONS: These data describe the burden of hernia repair in the U.S. The large variation in time between diagnosis and repair by hernia type identifies an important area of research to understand mechanisms underlying such heterogeneity and determine the ideal timing for repair. LEVEL OF EVIDENCE: Prognosis study II.
Assuntos
Hérnia Femoral/epidemiologia , Hérnia Inguinal/epidemiologia , Hérnia Umbilical/epidemiologia , Hérnia Ventral/epidemiologia , Herniorrafia/estatística & dados numéricos , Parede Abdominal/cirurgia , Adolescente , Criança , Pré-Escolar , Feminino , Virilha/cirurgia , Hérnia Femoral/diagnóstico , Hérnia Femoral/cirurgia , Hérnia Inguinal/diagnóstico , Hérnia Inguinal/cirurgia , Hérnia Umbilical/diagnóstico , Hérnia Umbilical/cirurgia , Hérnia Ventral/diagnóstico , Hérnia Ventral/cirurgia , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Prevalência , Estudos RetrospectivosRESUMO
Background and Objectives: Less than 300 cases of a De Garengeot's hernia have been published. This rare femoral hernia with the vermiform appendix included appears almost exclusively on the right side, mainly in females, and it generally debuts as an incarcerated femoral hernia. Although most of the times there is a concomitant appendicitis, clinical signs of peritonitis are absent. The wide use of radiologic exams has not favored its preoperative diagnosis, but been usually found incidentally during a surgical emergency. The best surgical approach to a De Garengeot's hernia is not totally defined and many critical questions still remain unanswered. Open surgery is considered the standard treatment procedure, but since the emergence of laparoscopy for incarcerated hernias, this is certainly an option. Methods: We report the successful laparoscopic management of an 83-year-old woman who had been operated on her right inguinal hernia, with a Rutkow-Robbins' technique, 4 months earlier. She had noticed the protrusion of a lump in her right inguinal region for 2 months. Radiological studies were not conclusive. With a miss diagnosis of a recurrent incarcerated inguinal hernia, a minimal invasive endoscopic approach was performed. A representative case of this fully laparoscopic TAPP procedure is presented. Results: The patient made an uninterrupted recovery. She left the hospital the day after in a stable condition and has enjoyed good health since. Conclusion: A fully laparoscopic TAPP approach seems perfectly safe and feasible to treat this entity, and could be considered the first line alternative when enough expertise is available.
Assuntos
Apêndice , Hérnia Femoral , Hérnia Inguinal , Laparoscopia , Idoso de 80 Anos ou mais , Apendicectomia/métodos , Apêndice/cirurgia , Feminino , Hérnia Femoral/diagnóstico , Hérnia Inguinal/diagnóstico , Herniorrafia/métodos , Humanos , Laparoscopia/métodosRESUMO
De Garengeot's hernia, the presence of an incarcerated vermiform appendix within a femoral hernia, is a rare general surgery emergency that predominantly affects elderly female patients. Due to its rarity, there is significant variation in surgical technique; however, most case reports favor an open approach. Here we present a case of a De Garengeot's hernia with a unique hybrid open and laparoscopic repair, utilizing the hernia defect as a port site. We will also review the relevant literature.
Assuntos
Apendicite/etiologia , Apendicite/cirurgia , Hérnia Femoral/complicações , Hérnia Femoral/cirurgia , Herniorrafia/métodos , Idoso de 80 Anos ou mais , Apendicite/diagnóstico , Feminino , Hérnia Femoral/diagnóstico , Humanos , Laparoscopia/métodosRESUMO
A 7-year-old girl was referred to our hospital with a suspected right-sided indirect inguinal hernia. An egg-sized elastic, non-painful mass was palpated in the right inguinal region. Preoperative CT demonstrated a 30-mm simple cystic mass in the right internal inguinal canal, which we diagnosed as an abdominal cyst of the canal of Nuck. Laparoscopy revealed that the abdominal cystic component was ruptured, so we performed Pott's procedure. However, the patient's right groin swelled on postoperative day 3, necessitating re-operation. The patient's symptoms recurred again after 3 months, despite having had two surgical repairs. In the third operation, a right-sided femoral hernia was confirmed and repaired via external and laparoscopic approaches. To the best of our knowledge, there have been no reports on the combination of femoral hernia and cyst of the canal of Nuck in children. A laparoscopic approach was useful for obtaining a definitive diagnosis and conducting a safe and secure surgical repair.
Assuntos
Cistos , Hérnia Femoral , Laparoscopia , Doenças Peritoneais , Criança , Cistos/complicações , Cistos/diagnóstico , Cistos/cirurgia , Feminino , Hérnia Femoral/complicações , Hérnia Femoral/diagnóstico , Hérnia Femoral/cirurgia , Humanos , Canal Inguinal/anormalidades , Canal Inguinal/cirurgia , Doenças Peritoneais/complicações , Doenças Peritoneais/diagnóstico , Doenças Peritoneais/cirurgia , Recidiva , Reoperação , Ruptura EspontâneaRESUMO
INTRODUCCIÓN: Las hernias femorales son raras en la infancia. El defecto está abajo del ligamento inguinal. La frecuencia de un diagnóstico erróneo es de hasta el 75%. Pueden ser resueltas mediante cirugía abierta o laparoscópica. OBJETIVO: Comunicar el caso de un niño con hernia femoral resuelto mediante laparoscopía. CASO CLÍNICO: Varón de 5 años, con antecedente de criptorquidia bilateral resuelta a los 2 años de edad. Padecimiento actual con 1 mes de evolución, con aumento de volumen en el tercio externo de la ingle. El ultrasonido reportó un defecto aponeurótico junto a los vasos femorales derechos. Abordaje laparoscópico, con hallazgos de defecto por abajo del ligamento inguinal. Sin recidiva a los 12 meses de seguimiento. DISCUSIÓN: Las hernias femorales son raras en los niños y su diagnóstico es difícil. La exploración laparoscópica permitió identificarla al encontrar un defecto por abajo del ligamento inguinal y junto a los vasos femorales independiente del anillo inguinal profundo y de la fascia transversal. INTRODUCTION: Femoral hernias are rare in children. The defect is below the inguinal ligament. The frequency of a misdiagnosis is up to 75%. They can be resolved by open or laparoscopic surgery. OBJECTIVE: To report the case of a child with femoral hernia, resolved by laparoscopy. CASE REPORT: Male, 5 years old, with a history of bilateral cryptorchidism resolved at 2 years of age. Current condition with a month of evolution with an increase in volume in the outer third of the groin. Ultrasound reported aponeurotic defect along with the right femoral vessels. Laparoscopic approach, with defect findings below the inguinal ligament. No recurrence at 12 months follow-up. DISCUSSION: Femoral hernias are rare in children, their diagnosis is difficult. Laparoscopic examination allowed its identification, finding a defect below the inguinal ligament and adjacent to the femoral vessels independent of the deep inguinal ring and the transversalis fascia.
Assuntos
Hérnia Femoral , Laparoscopia , Criança , Pré-Escolar , Hérnia Femoral/diagnóstico , Hérnia Femoral/cirurgia , Humanos , Masculino , UltrassonografiaRESUMO
BACKGROUND: Differential diagnosis of inguinal mass must include, especially in female patients, a wide variety of lesions among which our analysis will focus on mesothelial cyst of the round ligament of the uterus. A rare developmental lesion often misdiagnosed as hernias and accidentally detected during surgical exploration of the groin region. CASE REPORT: Of a left inguinal mass causing local discomfort and progressive worsening of local pain. A pre-operative diagnosis of left symptomatic femoral hernia was made and the patient consented to surgical treatment. The surgical exploration of the inguinal and femoral canals revealed a femoral hernia associated to a clear fluid cystic lesion of around 2 cm arising from the round ligament. Histopathology demonstrated a mesothelial cyst of the round ligament CONCLUSIONS: Mesothelial cysts of the round ligament of the uterus must be taken into consideration in the differential diagnosis of groin swelling in female patients and a greater effort is needed in order to reach a preoperative diagnosis and prevent an over treatment. Key words: Mesothelial cyst, Preoperative diagnosis, Uterus.