Abstract:

Objective

To improve the early diagnosis rate of complete androgen insensitivity syndrome （CAIS） by examining internal genital organs during laparoscopic treatment of inguinal hernia in female pediatric patients.

Methods

A retrospective analysis was conducted on the clinical data of 536 female pediatric patients with inguinal hernia who underwent laparoscopic treatment during menstruation at Shanxi Children's Hospital from January 2012 to December 2021. During surgery， the condition of the pelvic cavity and bilateral internal inguinal rings was observed. If a normal uterus， fallopian tubes， and ovaries were present， standard purse-string closure of the patent internal ring was performed.

Results

In this group of cases， three patients had no normal internal genital organs in the pelvic cavity. If the gonads were located at the internal ring， they were pulled into the abdominal cavity， and the internal ring was closed with a purse-string suture. Among female pediatric patients undergoing laparoscopic surgery for inguinal hernia， three cases without internal genital organs were found. Further karyotype and genetic testing confirmed the diagnosis of CAIS in all three cases.

Conclusion

CAIS is a rare disease. The incidence of CAIS is relatively high in female pediatric patients with inguinal hernia. During laparoscopic treatment of inguinal hernia in female pediatric patients， routine intraoperative examination of internal genital organs is a simple and effective method for screening CAIS， which can achieve the goal of early diagnosis. During surgery， if gonads are found at the internal ring and no uterus or fallopian tubes are found in the pelvic cavity， CAIS should be considered， and further karyotype and genetic testing should be performed to confirm the diagnosis.

Key words: Hernia, inguinal, Laparoscopy, Complete androgen insensitivity syndrome, Female pediatric patients