Current Medical Science

, Volume 38, Issue 6, pp 1032–1037 | Cite as

Risk Factors for Strangulated Ovarian Hernia in Female Infants: the Role of Ovarian Volume

  • Yu Chen
  • Xiang-zhi Peng
  • Wei Lu
  • Kai Zheng
  • Jian Guo
  • Hua Nie
  • Xiao-jie Song
  • Yan Zhang
  • Jing YangEmail author


The risk factors associated with strangulated ovarian hernia (SOH) in female patients (<1 year old) were identified. A retrospective analysis was conducted regarding the data from 2006 to 2017. The patients were divided into 2 groups: SOH group (n=9) and non-SOH group (n=23). Patient demographics, clinical signs, preoperative examinations and intraoperative findings were compared between the two groups, and risk factors for SOH were tested using a binary logistic regression model. To explore whether greater ovary was more likely to be twisted, leading to SOH, all the patients were divided into ovary volume <5 cm3 and ≥5 cm3 groups and the association between ovarian volume and ovary torsion was assessed. Among a total of 32 female patients (<1 year old) with incarcerated ovarian herniation, 9 patients developed SOH. The single variate analysis revealed that times of manual reduction, ovarian volume, ovary with or without multiple cysts, ovary torsion or not and angle of ovary torsion were found to be significant factors associated with SOH. The multivariate analysis showed ovarian volume was evidenced as an independent risk factor for SOH. Furthermore, the incidence of ovary torsion was significantly higher in ovarian volume ≥5 cm3 group than in ovarian volume <5 cm3 group, indicating that larger ovary was more likely to result in ovary torsion, leading to SOH. Our study demonstrated that the odds of SOH increased with increasing ovarian volume in female patients (<1 year old) because the relatively greater ovary at this age was more likely to be incarcerated and twisted, leading to SOH.

Key words

inguinal hernia incarceration ovary strangulation risk factors pediatrics 


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  1. 1.
    George EK, Oudesluys-Murphy AM, Madern GC, et al. Inguinal hernias containing the uterus, fallopian tube, and ovary in premature female infants. J Pediatr, 2000,136(5):696–698CrossRefGoogle Scholar
  2. 2.
    Bronsther B, Abrams MW, Elboim C. Inguinal hernias in children—a study of 1, 000 cases and a review of the literature. J Am Med WomensAssoc, 1972,27(10):522–525Google Scholar
  3. 3.
    Merriman TE, Auldist AW. Ovarian torsion in inguinal hernias. Pediatr Surg Int, 2000, 16(5-6):383–385CrossRefGoogle Scholar
  4. 4.
    Choi KH, Baek HJ. Incarcerated ovarian herniation of the canal of Nuck in a female infant: Ultrasonographic findings and review of literature. Ann Med Surg (Lond), 2016,18(9):38–40CrossRefGoogle Scholar
  5. 5.
    Boley SJ, Cahn D, Lauer T, et al. The irreducible ovary: a true emergency. J Pediatr Surg, 1991,26(9):1035–1038CrossRefGoogle Scholar
  6. 6.
    Takehara H, Hanaoka J, Arakawa Y. Laparoscopic strategy for inguinal ovarian hernias in children: when to operate for irreducible ovary. J Laparoendosc Adv Surg Tech A, 2009, 19(Suppl 1):S129–S1131CrossRefGoogle Scholar
  7. 7.
    Cohen HL, Shapiro MA, Mandel FS, et al. Normal ovaries in neonates and infants: a sonographic study of 77 patients 1 day to 24 months old. AJR Am J Roentgenol, 1993,160(3):583–586CrossRefGoogle Scholar
  8. 8.
    Garel L, Dubois J, Grignon A, et al. US of the pediatric female pelvis: a clinical perspective. Radiographics, 2001,21(6):1393–1407CrossRefGoogle Scholar
  9. 9.
    Kitami M. Ultrasonography of pediatric urogenital emergencies: review of classic and new techniques. Ultrasonography, 2017,36(3):222–238CrossRefGoogle Scholar
  10. 10.
    Oltmann SC, Fischer A, Barber R, et al. Cannot exclude torsion—a 15-year review. J Pediatr Surg, 2009,44(6):1212–1216; discussion 7CrossRefGoogle Scholar
  11. 11.
    Kristiansen CT, Snyder WH Jr. Inguinal hernia in female infants and children. West J Surg Obstet Gynecol, 1956,64(9):481–484Google Scholar
  12. 12.
    Friedman D, Schwartzbard A, Velcek FT, et al. The government and the inguinal hernia. J Pediatr Surg, 1979,14(3):356–359CrossRefGoogle Scholar
  13. 13.
    Harper RG, Garcia A, Sia C. Inguinal hernia: a common problem of premature infants weighing 1, 000 grams or less at birth. Pediatrics, 1975,56(1):112–115Google Scholar
  14. 14.
    Değirmenci NA, Ozkan IR, Ilhan H. Case report: Ovarian torsion in inguinal canal. Tani Girisim Radyol, 2003,9(3):388–390Google Scholar
  15. 15.
    Bittner JG 4th. Incarcerated/Strangulated Hernia: Open or Laparoscopic? Adv Surg, 2016,50(1):67–78CrossRefGoogle Scholar
  16. 16.
    Naiditch JA, Barsness KA. The positive and negative predictive value of transabdominal color Doppler ultrasound for diagnosing ovarian torsion in pediatric patients. J Pediatr Surg, 2013,48(6):1283–1287CrossRefGoogle Scholar
  17. 17.
    Mashiach R, Melamed N, Gilad N, et al. Sonographic diagnosis of ovarian torsion: accuracy and predictive factors. J Ultrasound Med, 2011,30(9):1205–1210CrossRefGoogle Scholar
  18. 18.
    Fleischer AC, Brader KR. Sonographic depiction of ovarian vascularity and flow: current improvements and future applications. J Ultrasound Med, 2001,20(3):241–250CrossRefGoogle Scholar
  19. 19.
    Hyun PM, Jung AY, Lee Y, et al. CT and US findings of ovarian torsion within an incarcerated inguinal hernia. Emerg Radiol, 2015,22(1):91–94CrossRefGoogle Scholar

Copyright information

© Huazhong University of Science and Technology 2018

Authors and Affiliations

  • Yu Chen
    • 1
  • Xiang-zhi Peng
    • 2
  • Wei Lu
    • 3
  • Kai Zheng
    • 4
  • Jian Guo
    • 5
  • Hua Nie
    • 5
  • Xiao-jie Song
    • 5
  • Yan Zhang
    • 5
  • Jing Yang
    • 1
    Email author
  1. 1.Reproductive Medicine CenterRenmin Hospital of Wuhan UniversityWuhanChina
  2. 2.Reproductive Medicine Center, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  3. 3.Department of Neonatal Surgery, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  4. 4.Department of General Surgery, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  5. 5.Department of Obstetrics and Gynecology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina

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