Concomitant closure of patent canal of Nuck during laparoscopic surgery: case report

Cyst of the Canal of Nuck in adult females: A case report and systematic review

Defects in the Canal of Nuck are rare abnormalities of the female genitalia, which are typically detected and repaired in young age. In the present report, a case of a Nuck cyst in a 40-year old female patient is described. Additionally, the current literature concerning cases of women with hydrocele of Nuck canal was systematically reviewed. A total of 16 case reports of 16 patients with Nuck hydrocele (mean age of 35.18 years), have been reported to date. A right inguinal mass was noted in 13 patients (81.3%) whereas in 3 patients a left-sided mass was noted. The surgical approach was open in 13 cases and laparoscopic in 3 cases. Two cases underwent hydrocelectomy and inguinal ring ligation, whereas in 7 cases a simple cystectomy was performed. In 2 cases the round ligament was excised along with the hydrocele. In one of these 2, ligamentum rotundum necrosis and presence of a haemorrhagic cyst of the canal of Nuck were identified. Hernia repair and hydrocelectomy was performed in 5 cases. A cyst of the Canal of Nuck is relatively rare, but should be considered during the diagnosis of inguinal masses in female patients.

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.

A laparoscopic approach to Nuck's duct endometriosis

OBJECTIVE

To report a case of uncommon endometriosis located in the Nuck's duct and its laparoscopic resolution.

DESIGN

Case report.

SETTING

Gynecologic department at 12 de Octubre University Hospital, Madrid.

PATIENT(S)

A 35-year-old woman, gravida 1 para 1, presented with an inguinal right mass. She had a right nephrectomy because of acute pyelonephritis. Computed tomography showed a cystic lesion that was suggestive of a Nuck's duct cyst. Fine-needle aspiration cytology was performed, and endometriosis was determined.

INTERVENTION(S)

Cyst removal and closure of the internal inguinal ring's defect by the laparoscopic approach.

MAIN OUTCOME MEASURE(S)

Disease free.

RESULT(S)

The intervention was successfully performed by laparoscopic approach. The postoperative evolution was good, and the patient was discharged 2 days after surgery.

CONCLUSION(S)

Inguinal or Nuck's duct are both uncommon locations for endometriosis; therefore, it is difficult to suspect in patients without a surgical history. Once identified, the treatment involves removal of the endometrioma and repair of the internal inguinal ring. A laparoscopic approach should be considered when possible.

Challenge in the management of endometriosis in the canal of Nuck

OBJECTIVE

To report a case of endometriosis located at an unusual site in the canal of Nuck.

DESIGN

Case report.

SETTING

Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital.

PATIENT(S)

A 35-year-old woman with no previous history of surgery had endometriosis in the canal of Nuck excised incompletely via an open skin method. Recurrent endometriosis at the canal of Nuck was noted 9 months later despite postoperative medical treatment.

INTERVENTION(S)

Laparoscopic surgery and open skin method.

MAIN OUTCOME MEASURE(S)

Removal of endometriosis in the canal of Nuck and repair of the inguinal ring.

RESULT(S)

The patent left canal of Nuck identified, endometriosis completely resected, and the inguinal ring closed. She was well 12 months after the second surgery.

CONCLUSION(S)

We suggest that when encountering endometriosis in the canal of Nuck, removing all involved lesions and closing of the internal inguinal ring is indicated.