Female with multiple groin pathologies: inguinal hernia containing fallopian tube, obturator hernia and subcutaneous endometrioma

Groin lumps in females can be challenging due to unique anatomy and vast differential diagnostic pathologies. We report the case of a 39-year-old female presenting with a six-month history of painful left groin lump. Laparoscopic total extraperitoneal (TEP) hernia repair showed an incarcerated left indirect inguinal hernia sac containing part of the left fallopian tube and fimbrial cyst, a left fat-containing obturator hernia and associated with ectopic subcutaneous inguinal endometrioma. The anatomical differences in women suggest that individualized preoperative imaging modalities such as magnetic resonance imaging have a place before considering laparoscopic hernia repair, to successfully identify and synchronously treat any concomitant pathologies.