Abstract: Endometriosis in a hernia sac is rare. We present two cases diagnosed subsequent to inguinal hernia repair surgery. A review of the 17 reported cases including the present cases revealed that endometriosis was more commonly found in right inguinal hernias and the mean age of presentation was 38.6 years. The average size of the hernia sacs was 5.4cm. In 23% of the patients hernial endometriosis was associated with pelvic endometriosis. 37.5% of the women were nulliparous. The incidence of endometriosis in adult hernia sacs in our material is 0.256% (0.784% in women). It is usually an incidental finding but surgeons and pathologists should be aware of this diagnostic possibility so that it can be adequately treated.

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