Children with Hernias, Testes, and Female External Genitalia

Any doctor dealing with infants and children may encounter patients with inguinal hernias. We have seen three young patients with the external characteristics of females, each of whom had inguinal hernias. Subsequently, these children were proved to have testes within their inguinal canals and to have no internal female genitalia. Such cases present multiple problems in management.

There is adequate authority for recommending surgical repair of inguinal hernias early in infancy and childhood.* Only approximately 10% of such hernias occur in females. Although most authors state that an ovary and Fallopian tube may be found in the hernial sac of a female child, few of them state the incidence of this finding. Gross¹ does not mention it in the 10% of females in his series of more than 8000 cases of inguinal hernia in infants and children. Potts, Riker, and Lewis² recorded three sliding hernias of the ovary