To explore ultrasonic manifestations and clinical features of inguinal ovarian hernia (IOH) in female infants and review related literature.

One case of a girl (child 1) with left IOH, aged 11 months and 20 days, who was treated in West China Second University Hospital, Sichuan University on December 21, 2020 was selected as research subject. Her ultrasonic manifestations and clinical data were collected by retrospective analysis method. Her ultrasonic manifestations, clinical features, treatment and prognosis were summarized. With the following key words of " ovarian hernia" " infant" " ultrasound" " inguen" " incarcerated hernia" in both Chinese and English, literature related to IOH in infants was searched from China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform and PubMed. Literature retrieval time was set from January 1, 2010 to December 31, 2022. The procedures followed in this study complied with the requirements of newly revised Helsinki Declaration of the World Medical Association in 2013.

①Child 1 was an 11 months and 20 days old female infant who was admitted to case collected hospital for treatment due to a left inguinal mass(IM) for 10⁺ months. Bilateral inguinal color Doppler ultrasound at admission showed that child 1 had bilateral inguinal hernia (contents of left hernia were ovary and intestine, and content of right hernia was intestine), and blood flow signals were detected in both bilateral masses. Child 1 received bilateral inguinal hernia repair under laparoscope, and the condition improved, and discharged from hospital 3 days after surgery. ②Literature review results: according to the retrieval strategy set in this study, 28 pieces of literature related to ultrasound diagnosis of IOH in infants were retrieved, involving 68 female children ≤ 6 years old with IOH (child 2-69). The clinical data analysis results of 69 children with IOH (child 1 to 69) were as follows. A total of 65 children had the first symptom of an IM, while 4 children combined with repeated crying. All 69 children underwent surgical treatment, and 67 cases had unilateral ovarian hernia confirmed during surgery (33 cases combined with ovarian incarceration, 3 cases combined with fallopian tube hernia, 3 cases combined with uterine hernia and 4 cases combined with bilateral ovarian and uterine herniated into unilateral inguinal region), and 2 cases had bilateral IOH (both combined with ovarian incarceration). And 13 children had ovarian necrosis (preoperative color Doppler ultrasound of 12 cases showed the mass in inguinal without any blood flow signal, just 1 case had; 12 children underwent surgical removal of ovaries, including 2 cases combined with ovarian torsion, one child remain the ovary, which was atrophying severely during the ultrasound follow-up). The other 56 children had a good prognosis after the ovary retraction during operation.

Ultrasonography can help clinicians to diagnose IOH in infants, and the main ultrasonic feature is ovarian echoes in inguinal region. Surgery is the main treatment for IOH in infants. For female infants with IM, clinicians should be alert to the possibility of IOH. Early diagnosis and timely treatment can avoid ovarian necrosis and preserve ovary functions of infants with IOH.