Bilateral Hydrocele of the Canal of Nuck in an Adult Female: A Case Report

Abstract

Bilateral hydrocele of the canal of Nuck (HCN) is very rare, in adult females. Primary care physicians can misdiagnose this pathology without diagnostic imaging. A 37-year-old female complained of right lower quadrant (RLQ) pain, for a few months, reported to the emergency room. A non-reducible bulging protrusion was visualized in the RLQ. After performing the necessary blood work, the emergency physician ordered an emergent sonogram and computed tomography (CT). A transvaginal sonogram was performed to exclude gross adnexal masses, in the RLQ. An HCN canal was suspected in the right inguinal region. A non-contrast CT demonstrated a bilateral HCN, with the left significantly smaller than the right. In this case, a bilateral surgical excision of the hydrocele was recommended. Owing to the recurrence of the HCN, a cyst aspiration was not suggested. Physicians should consider the diagnosis of HCN in any female presenting with inguinolabial swelling. Sonography, CT, and magnetic resonance imaging (MRI) are the three diagnostic imaging techniques commonly used to diagnose this pathology. A multimodality approach is sometimes necessary when the sonography diagnosis is no definitve.