The authors describe an unusual rare presentation of endometriosis in a hydrocoele of the canal of Nuck. A 43-year-old lady presented with a swelling in her right groin associated with mild discomfort. Examination revealed a cystic swelling in the groin for which she underwent an exploration and excision of the swelling. Surgery revealed a hydrocele of the canal of Nuck which was confirmed histologically. The unusual presentation of endometriosis in the sac was confirmed immunocytochemically.

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INTRODUCTIONHepatic abscesses are classified as those of bacterial origin or by Entamoeba-histolytica but modern times have seen a major shift in etiology of pyogenic abscesses in the liver.1 This remains a serious condition with high morbidity and mortality, despite advances in diagnostic and therapeutic modalities. Liver abscesses commonly occur secondary to biliary or intestinal tract infections, haematogenous seeding or extension of contiguous infection, and carry a mortality rate of 20-60% even with appropriate medical-surgical management. The most common presenting clinical symptoms are abdominal pain, fever, nausea, vomiting, loss of appetite and jaundice. These symptoms are variable depending upon size of abscess, general health of the patient, associated chronic diseases and complications, poor hygiene, contaminated drinking water, malnutrition, hepatic dysfunction, low host resistance, alcohol intake, delayed or inadequate treatment are all responsible for the disease in the low socio economic group. Liver abscesses usually occur in older, more debilitated patients, often in the setting of malignancy. The incidence of pyogenic liver abscess is on the rise. The majority of large series published over the past 20 years cite biliary disorders as the most common identifiable source of the hepatic ABSTRACT Background: Liver abscesses commonly occur secondary to biliary or intestinal tract infections, haematogenous seeding or extension of contiguous infection, and carry a mortality rate of 20-60% even with appropriate medicalsurgical management. The aims of the study were to study the current prevelence of etiological factors in cases of liver abscess, to study clinical presentations in cases of liver abscess and study outcomes of the current trend in investigations and outcomes of the modes of treatment in cases of liver abscess. Methods: 50 patients with the diagnosis of liver abscess belonging to various age groups and socio-economic status are included in the study. Written consent and a pre designed proforma was taken from all the patients and to collect relevant data form the patients included in the study. Results: In our study of 50 cases of liver abscess age ranges from 16 to 65, with majority of patients being in young age group (14-34 years). The median age for our study of liver abscess is 31. In our study, there were number of males 41 (82%) greater than females 9 (18%). In our study, right hypochondrium pain 12 cases (24%) was the most common presenting symptom among all liver abscess. Conclusions: Percutaneous aspiration along with medical management yields far better results. Ultrasonography is the most important recommended tool for the initial diagnostic investigation in liver abscess cases with percutaneous aspiration and pigtailing. Hence the prognosis of liver abscess has been improved with different advanced modalities in the management of liver abscess with less or no mortality except in patients with malignant disease.

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