CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2018; 28(01): 41-44
DOI: 10.4103/ijri.IJRI_178_17
Genitourinary Radiology

Hernia uteri inguinalis in ovotesticular disorder of sexual differentiation: A rare complication and role of imaging

Janardhana Ponnatapura
Department of Radiodiagnosis, Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India
› Author Affiliations

Subject Editor: Financial support and sponsorship Nil.

Abstract

Neonate with ambiguous genitalia can cause great apprehension for the family as well as for healthcare providers. We report a rare complication of delayed diagnosis of hernia uteri inguinalis in ovotesticular disorder of sexual differentiation (DSD) in 20-year-old male patient who presented with pain and swelling in left inguinal region since 1 month. He had a past surgical history of repair of hypospadias 10 years back. On imaging, the left inguinal hernia sac contained nonfunctioning uterus and one ovary in the left scrotal sac and one testis in the right scrotal sac. Further investigation confirmed genotypically female (46XX) with negative sex determining region-Y gene on fluorescence in situ hybridization. The patient was given psychiatric counseling and wished to remain as male. The left inguinal hernia was repaired with excision of nonfunctioning uterus, ovary, and fallopian tube. Hernia uteri inguinalis is rare complication seen in DSD with only three cases being reported worldwide thus far, including our case.



Publication History

Article published online:
26 July 2021

© 2018. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 
  • References

  • 1 Wright NB, Smith C, Rickwood AM, Carty HM. Imaging children with ambiguous genitalia and intersex states. Clin Radiol 1995; 50: 823-9
  • 2 Sax L. How common is intersex? A response to Anne Fausto-Sterling. J Sex Res 2002; 39: 174-8
  • 3 Hughes IA, Houk C, Ahmed SF, Lee PA. LWPES Consensus Group; ESPE Consensus Group. Consensus statement on management of intersex disorders. Arch Dis Child 2006; 91: 554-63
  • 4 Allen L. Disorders of sexual development. Obstet Gynecol Clin North Am 2009; 36: 25-45
  • 5 Josso N, Belville C, Di Clemente N, Picard JY. AMH and AMH receptor defects in persistent Mullerian duct syndrome. Hum Reprod Update 2005; 11: 351-6
  • 6 Pasterski V, Prentice P, Hughes IA. Impact of the consensus statement and the new DSD classification system. Best Pract Res Clin Endocrinol Metab 2010; 24: 187-95
  • 7 Ocal G. Current concepts in disorders of sexual development. J Clin Res Pediatr Endocrinol 2011; 3: 105-14
  • 8 Moshiri M, Chapman T, Fechner PY, Dubinsky TJ, Shnorhavorian M, Osman S. et al. Evaluation and management of disorders of sex development: Multidisciplinary approach to a complex diagnosis. Radiographics 2012; 32: 1599-618
  • 9 Mansour SM, Hamed ST, Adel L, Kamal RM, Ahmed DM. Does MRI add to ultrasound in the assessment of disorders of sex development?. Eur J Radiol 2012; 81: 2403-10
  • 10 Venkataraman A, Shivaswamy S, Babu R, Santhosh S. Hernia uteri inguinalis in a case of ovotesticular disorder of sexual differentiation. J Pediatr Adolesc Gynecol 2013; 26: 17-9
  • 11 Ceylan K, Algun E, Gunes M, Gonulalan H. True hermaphroditism presenting as an inguinal hernia. Int Braz J Urol 2007; 33: 72-3