Uterus-containing inguinal hernia caused by undue tension on round ligament

The presence of uterus in inguinal hernia sac is a rare condition, the cause for this disease has not been clarified, and the contributions to this condition could be multiple. In this report, we described a case of a 78-year-old multiparous female with left recurrent inguinal hernia, during the transabdominal preperitoneal repair (TAPP); the well-formed uterus was found in the hernia sac, and the uterus could only be completely reduced after the division of the left round ligament. To the best of our knowledge, there have been no reports in the literature on adult recurrent hernias containing well-formed uterus in adult females. The aim of this case report is to call attention to the proper management of round ligament when performing inguinal hernia repair in female patients.