腹腔鏡下手術にて診断・治療し得た、Mayer-Rokitansky- Küster-Hauser Syndrome (MRKH)に伴う、痕跡子宮の鼠径ヘルニア嵌頓の一症例

抄録

Objective: To report a case of inguinal hernia of a rudimentary uterus associated with Mayer-Rokitansky-Küster-Hauser syndrome (MRKH), successfully diagnosed and treated with laparoscopic surgery, and to present a review of the past literature

Design: Case report and literature review

Patient(s): A 49-year-old woman

Intervention(s): Ultrasound, computerized tomography, magnetic resonance imaging, hormone analysis, and laparoscopic surgery

Main outcome, Measure(s): Accuracy of diagnosis and laparoscopic resection of hernia contents

Result: Based on the sonographic and the corroborating MRI findings, a diagnosis of post-coloplasty MRKH and inguinal herniation of a right ovarian tumor was made. Laparoscopic surgery was performed for the resection of the hernia contents. Intraoperative observation revealed that the uterus was divided into two sections, left and right, in the pelvic cavity and the hernia content was not the right ovarian tumor, but the right uterus and adnexa.

  The herniated uterus and adnexa were successfully resected laparoscopically without any complication. Pathological examination revealed a uterus without a normal endometrium. The post-operative diagnosis, based on the intraoperative findings and pathological examination, was inguinal hernia of a right rudimentary uterus and adnexa with MRKH.

Conclusion: There are few reports of inguinal hernia of the uterus and adnexa. Even if the diagnosis of MRKH is made preoperatively, it is almost impossible to identify the hernia sac's contents. The laparoscopic approach is less invasive than the abdominal approach, has several advantages, and offers excellent results in the diagnosis and treatment of these disorders.