Ultrasound and hookwire needle placement for localization of a hydrocele of the canal of Nuck

Hydrocele and endometriosis of the canal of Nuck in two adults: a look at the imaging features

We present a report of two adult females who presented to the surgery clinic at different time frames in our hospital with a swelling in the inguinal region. The swelling was painful for one of our patients. The first patient was evaluated with a contrast-enhanced CT and an MRI, while the second patient underwent a ultrasonography and an MRI. Imaging revealed the structure to be cystic in nature and confirmed the diagnosis as a hydrocele of the canal of Nuck in both patients. Our second patient was also found to have concomitant endometriosis, with internal septations seen in the hydrocele. Aspiration revealed altered blood with haemosiderin deposition, which established a diagnosis of endometriosis of the canal of Nuck. The first patient underwent excision, while the second patient refused a surgical approach and opted for medical management for endometriosis.

Laparoscopic Percutaneous Extraperitoneal Closure for Hydrocele of the Canal of Nuck in Children

Background: Hydrocele of the canal of Nuck (HCN) is a rare cause of inguinal swelling in women. The optimal surgical procedure for HCN in children remains unclear. To assess the safety and efficacy of laparoscopic percutaneous extraperitoneal closure (LPEC) for HCN in a pediatric population, a retrospective study was conducted. In addition, to clarify the pathogenesis of HCN, we assessed the morphological findings of the internal inguinal ring (IIR). Materials and Methods: We retrospectively analyzed 10 consecutive female patients with HCN who underwent LPEC at our hospital between January 2010 and May 2020. Age, operative time, and complications were recorded. Concerning the findings of the IIR, we classified the morphological features as follows: Type 1 (flat), Type 2 (narrow patent processus vaginalis [PPV] with a peritoneal veil), and Type 3 (widely opening PPV). Results: The median age of patients who underwent LPEC was 3 (1-12) years. Although 2 patients showed contralateral inguinal hernia (IH), there were no cases of ipsilateral IH. All patients showed ipsilateral PPV, and the morphological features of the IIR were mostly classified as Type 3 (70%). In total, 6 of 8 HCN cases without preoperatively diagnosed contralateral IH had contralateral PPV (75%), and all were closed by LPEC. All operations were accomplished laparoscopically, and the postoperative course was uncomplicated, with no recurrences observed during the study period. Conclusions: LPEC is a safe and simple surgical approach to repair the HCN in children with minimal complications.

A cautionary approach to adult female groin swelling: hydrocoele of the canal of Nuck with a review of the literature

Hydrocoele of the canal of Nuck in an adult female is a rare entity and analogous to hydrocoele in males. Its usual presentation is in children, and its occurrence in adults is very uncommon, more so of the hour-glass variety. We report a case of a 38-year-old woman presenting with a right inguinal swelling of 3-month duration. On physical examination, the swelling was non-tender, cystic and irreducible. There was no cough impulse. Ultrasonography and contrast-enhanced CT revealed a cystic swelling with clear contents in the right inguinal region. Surgery was performed with excision of the cyst. The histopathology report suggested flat mesothelium cells, confirming the diagnosis.

Cyst of Canal of Nuck

A cyst of the canal of Nuck is a rare condition that occurs when the processus vaginalis fails to obliterate during embryologic development. When a nonreducible groin mass is seen in women and girls, a cyst of the canal of Nuck should be considered in the differential diagnosis. Sonography has shown to be accurate and reliable at diagnosing these cysts and should be the primary imaging modality used to image groin masses.

Hydrocele of the canal of Nuck: value of radiological diagnosis

Hydrocele of the canal of Nuck (cyst of the canal of Nuck) is the female homologue of hydrocele of the spermatic cord in males and is a rarely encountered entity, mostly diagnosed on the operating table at the time of suspected inguinal hernia surgery, as the clinical presentation usually is subtle and inconclusive. Diagnosis is mainly by ultrasound and has shown varied presentation of the same over the years. We discuss the sonographic findings of a case of hydrocele of the canal of Nuck.

Hydrocele of the canal of Nuck: imaging findings

The hydrocele of the canal of Nuck is quite a rare condition and results from the failure of obliteration of the distal portion of evaginated parietal peritoneum within the inguinal canal which forms a sac containing fluid. It generally presents with painless inguinal swelling. Ultrasonography and MRI is plays an important role to differentiate from the other conditions presenting with inguinal swelling. We present the imaging findings of a case in 5-year-old girl.

Haematoma in a hydrocele of the canal of Nuck mimicking a Richter's hernia

We report a haematoma in a hydrocele of the canal of Nuck in a 69-year-old female. She presented with a right-sided groin swelling, the differential for which included an irreducible inguinal hernia or haematoma given her aspirin and clopidegrel use. Successful treatment involved evacuation of the haematoma with excision of the sac. Despite a high index of suspicion for a haematoma, these swellings should ideally be explored given the potential for co-existence of a hernia.

Cysts of the canal of Nuck: ultrasound and magnetic resonance imaging findings

Cyst of the canal of Nuck is a rare cause of inguinal swelling in woman. We report a case of a cyst of the canal of Nuck in which sonography showed a tubular cystic structure with internal septae localized within the inguinal canal. Magnetic resonance examination demonstrated that the mass was hypointense on T1-weighted and hyperintense on T2-weighted series and that there were fine hypointense septae inside the mass on the T2-weighted sequence. Diagnosis of cyst of the canal of Nuck was confirmed by surgery and subsequent histopathologic evaluation.

Hydrocele of the canal of Nuck: sonographic and MRI appearances

Hydrocele of the canal of Nuck is a rare disorder in females. A 50-year-old female presented with the complaint of swelling and occasional pain in the right groin. Sonographic examination revealed a proximal dilatation at the inguinal canal with a 3-cm ovoid, septated cystic lesion at the distal end. The mass appeared as a simple cyst on MRI. Valsalva's maneuver during real-time sonography helped differentiate the hydrocele of the canal of Nuck from an inguinal hernia.

Sonographic appearance of canal of Nuck hydrocele

We present a case of a relatively uncommon entity in a 17-year-old girl who presented to the emergency department with right inguinal pain and discomfort. On sonography, she was thought to have a hydrocele of a patent processus vaginalis, although differentials could not be excluded. The hydrocele was subsequently confirmed at surgery. Because this is an uncommonly reported condition, a high index of suspicion must be maintained in the appropriate clinical setting. We present various sonographic appearances and techniques that have been proposed in the literature.