Differential diagnosis of an incarcerated inguinal hernia: extraperitoneal endometrioma of the round ligament

General surgeons may encounter endometriosis when extraperitoneal forms of the disease mimic a symptomatic inguinal hernia in premenopausal women. Diagnosis is often difficult, especially in the absence of menstrual symptoms, and is often made during surgical groin exploration. We present a case of extraperitoneal endometrioma simulating a symptomatic inguinal hernia and discuss the pathogenesis and management.