{"paper_id":"292a5ff8-ac2d-4485-b50b-69fca872478b","body_text":"Abstract\nBackground Inguinal hernias usually contain bowel loops or omentum. Herniation of the uterus and adnexa is exceedingly rare, particularly in adults. Most reported cases occur in infancy due to congenital anomalies such as a persistent canal of Nuck. Uterine incarceration in elderly nulliparous women without prior gynecologic surgery represents an exceptional clinical scenario. Case Presentation A 63-year-old nulliparous woman presented with acute-onset severe left inguinal pain and an irreducible groin mass. Ultrasonography suggested a strangulated inguinal hernia. Emergency surgical exploration revealed the uterus, left ovary, and fallopian tube within the hernia sac all exhibiting ischemic changes along with multiple uterine leiomyomas. In addition, the ovary demonstrated torsion with compromised vascularity. A lower midline laparotomy was performed, and hysterectomy with bilateral salpingo-oophorectomy was carried out in collaboration with gynecology. Standard herniorrhaphy followed. The postoperative course was uneventful, and the patient was discharged on day 2. Conclusion. This case highlights an exceptionally rare presentation of uterine inguinal hernia in an elderly woman, distinguished not only by the patient’s advanced age but also by the occurrence of uterine strangulation with vascular compromise and concurrent ovarian torsion. These unique features underscore the clinical significance of maintaining a high index of suspicion for such unusual hernia contents, as delayed recognition may result in life-threatening complications. Conclusion This case highlights an exceptionally rare presentation of uterine inguinal hernia in an elderly woman, distinguished not only by the patient’s advanced age but also by the occurrence of uterine strangulation with vascular compromise and concurrent ovarian torsion. These unique features underscore the clinical significance of maintaining a high index of suspicion for such unusual hernia contents, as delayed recognition may result in life-threatening complications.\nData Availability\nAll data generated or analyzed during this study are included in this article. Further inquiries can be directed to the corresponding authors.\nReferences\nKöckerling F, Koch A, Lorenz R (2019) Groin hernias in women-a review of the literature. Front Surg 6:4. https://doi.org/10.3389/fsurg.2019.00004\nBallas K, Kontoulis T, Skouras C, Triantafyllou A, Symeonidis N, Pavlidis T, Marakis G, Sakadamis A (2009) Unusual findings in inguinal hernia surgery: report of 6 rare cases. 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J Abdom Wall Surg 1:10586. https://doi.org/10.3389/jaws.2022.10586\nFunding\nThe study received no funding.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nConflict of interest\nThe authors have no conflicts of interest to declare.\nAdditional information\nPublisher’s Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nSpringer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.\nAbout this article\nCite this article\nAlkhatıb, M., Garip, H. A Double Trap: Uterine Incarceration and Ovarian Torsion Within a Strangulated Inguinal Hernia in an Elderly Nulliparous Woman. Indian J Surg (2025). https://doi.org/10.1007/s12262-025-04466-x\nReceived:\nAccepted:\nPublished:\nVersion of record:\nDOI: https://doi.org/10.1007/s12262-025-04466-x","source_license":"CC0","license_restricted":false}