Background: Hernia of the canal of Nuck is a rare congenital inguinal hernia in females due to persistence of the processus vaginalis. Pediatric inguinal hernia occurs in approximately 0.8–4.4% of children, with a 6–10-fold lower incidence in girls than in boys. Despite the lower incidence, strangulation is more frequent in girls, especially when the hernia contains the ovary and/or fallopian tube; reported strangulation rates may reach 43%, most commonly during the first year of life.
Objective: To report a strangulated canal of Nuck hernia in a female infant and review the literature on epidemiology, pathogenesis, clinical presentation, imaging diagnosis, complications, and management strategies.
Case presentation: An 11-month-old girl with bilateral canal of Nuck hernias was admitted with left-sided strangulation and underwent emergency surgery. She had a history of early inguinal swelling but did not receive timely follow-up or elective repair.
Conclusion: Early recognition and timely surgical repair of canal of Nuck hernias in girls are essential to prevent strangulation, preserve adnexal viability, and reduce emergency operations.