Infected Hydrocele of the Canal of Nuck

Abstract

Hydrocele of the canal of Nuck in children is rare. It may present as incarcerated inguinal hernia and necessitates emergency exploration. Risk of infection in hydrocele of the canal of nuck is very rare. We present a case report of a 5-year-old girl who presented with a left tender inguinolabial region swelling with fever, tachycardia, and mild dehydration. The clinical features were suggestive of strangulated left inguinal hernia and further imaging and surgical exploration revealed it to be an infected hydrocele of the canal of Nuck. High ligation and hydrocelectomy were performed. Hydrocele of the canal of Nuck in a female child presenting with an inguinal swelling should be considered in differential diagnosis.

Clinics in diagnostic imaging (183)

“…The canal of Nuck is usually obliterated at around the eighth month of fetal life. (3)(4) Hydrocoeles of the canal of Nuck typically present as an irreducible, painless swelling in the inguinolabial region that is sometimes transilluminable.…”

“…(3) However, the diagnosis of a hydrocoele in women is seldom made on clinical examination alone. In one-third of patients, a concomitant inguinal hernia is found.…”

“…• The canal of Nuck is usually obliterated at around the eighth month of fetal life (3)(4) • Irreducible painless swelling in the inguinolabial region • Classical history of lump disappearing when the patient wakes up after sleep and slowly reappearing over time when the patient remains in an upright position for a long time site for future inguinal hernia formation. Hence, most surgeons repair and reinforce the inguinal canal.…”

Laparoscopic Intracorporeal Hydrocelectomy and Posterior Wall Suture Repair of the Hydrocele for the Canal of Nuck

“…A few patients (3/30, 10%) with serous HCN had painful swelling, but most patients with hemorrhagic (11/12, 91.7%) and inflammatory (1/1, 100%) hydroceles complained of inguinal pain. Infected HCN has been described in some case reports on pediatric female patients [11,12] but not in adult women. Therefore, complicated hydroceles other than hernia can be distinguished if inguinal pain is the main symptom in adult patients.…”

Fetal vulvar cysts with spontaneous resolution

“…Cevik et al 7 report a case of urinary retention with hydronephrosis in a neonate with a Bartholin’s duct cyst compressing the urethra but diagnosed in the second day of life. Similarly, cyst of the canal of Nuck is a rare pathology,8 9 not reported in most textbooks of gynaecology or surgery,5 6 10 11 occurring in the paediatric population4 8 9 12 13 and in adult women 6 10–12 14. In the prenatal period, hydrocele is well documented only in male patients 15…”