'The intraabdominal bleeding with an inguinal defect that mimicking a femoral vein aneurysm'. A case report

Inguinal hernia repair is one of the most commonly performed operation in surgical practice. Sometimes, challenging cases may be encountered. An inguinal hernia can mimic many pathologies and become a surgical dilemma, even for the skilled surgeon [1]. The correct diagnosis of an inguinal mass is important in order to avoid performing non-therapeutic surgery and serious complications.We reported a patient who had been explorated with the diagnosis of inguinal hernia. The defect was diagnosed as femoral vein aneurysm in surgical exploration. The postoperative diagnostic imaging revealed that the inguinal defect had been confused as femoral vein aneurysm due to intra-abdominal hemorrhogical fluid after an ovarian cyst rupture. We concluded that an inguinal mass can be a diagnostic dilemma with treatment problems.Thirty-five years old female patient presented with pain and swelling in her left inguinal region. She was very thin in appreance. On physical examination, an inguinal mass, bulging with coughing about 3 × 4 cm in diameter was palpated. She had been operated for left ovarian cyst rupture about 8 years ago. She was diagnosed as inguinal hernia and prepared for elective inguinal hernia repair. The routine preoperative laboratory tests were within normal limits.The inguinal canal was explorated in operation. A lump, bluish-purple in color, about 3 × 4 cm in diameter was detected (Figure 1). It was emerging from the inferior part of the inguinal canal. It was accapted as a vascular lesion with it's appreance. The cardiovascular surgeon was invited for consultation. The dissection was performed up to the conjoint tendon and iliopubic tract. It was decided that the lesion was a femoral vein aneurysm and elective surgery should be recommended.We performed pelvic ultrasonography (USG) and pelvic Magnetic Resonance Imaging (MRI) postoperatively. Two ovarian cysts about 2.5 × 3.5 cm and 3 × 2.5 cm in diameter were detected in left ovary. There was also free hemorrhogic