Tam Metin PDF (4158 KB) - Marmara Medical Journal

Melih AKINCI et alTuba-ovarian inguinal herniationHowever, it relapsed one month later and itwas treated with drainage and sclerotherapy. Shehad no complaints for a period of two years. Thenext presentation was again a left inguinal painlessswelling which was controlled with ultrasound thatrevealed 5x4x3cm fluid collection at the samelocation and this collection was diagnosed as thelymphocele relapse. The Radiology Departmentperformed the same treatment of percutaneousdrainage and sclerotherapy. The control pouchgraphy did not show any extravasations. The patientwas discharged two days after sclerotherapy withthe drainage catheter. The outpatient follow up ofcatheter drainage volumes were 40ml, 40ml, 30ml,40ml and 30ml for five days respectively so thecatheter was not pulled out because of drainageflow was over 20ml per day. The patient wasadmitted to our clinic with a new painful left sidedswelling of groin at the seventh day of lymphoceletreatment (Figure 2). The ultrasonographic controlrevealed 35x 20mm of inguinal herniation sac.Surgery was planned because of severe pain at thephysical examination and high drainage oflymphocele catheter. The area was explored, withpresumed diagnosis of inguinal herniation. Atexploration torsion of the ovary and fallopian tubeswere found in the hernia sac (Figure 3-5). The bothstructures were ischemic, necrotic and edematousso salpingoopherectomy was performed. Herniarepair was performed after lymphocele cavity hadbeen obliterated. Post surgical course wasuneventful and she was discharged at the secondpostoperative day. Pathological examination of thespecimen was reported as ischemic necrotic fibroadipose tissue and intraovarian hemorrhage withedema. Eight months after surgery her control wasnormal and she had no complaint.Figure 2: Left sided swelling of groin at the seventhday of lymphocele treatmentFigure 3: Left groin hernia sacFigure 1: Image of recurred inguinal lymphocele oncomputerized tomography74Marmara Medical Journal 2011; 24 (1):73-77