Unusual presentation of bilateral abdominoscrotal hydrocele in a child

Abdominoscrotal hydrocele: its particular characteristics

“…In this manner, the ASH is a noncommunicating hydrocele. Similar findings were previously reported [3,12,15,28,31,32]. Perhaps, the identification of a PPV by several authors was an incorrect appreciation of the facts, and the portion of the ASH that goes through the IIR was misdiagnosed as a PPV.…”

“…Abdominoscrotal hydrocele has also been associated with secondary ureterohydronephrosis [12,22,23], lymphedema [24,25], appendicitis [26], intralesional hemorrhage [27], infection [28], cryptorchidism [14], crossed testicular ectopia [6], and paratesticular malignant mesothelioma [29].…”

Abdominoscrotal hydrocele: when one sac becomes bissac

“…Regarding the last topic, however, most authors deem ASH a non‐communicating hydrocele explaining that a PPV is practically impossible to find in such a condition . Usually, the abdominal component is unilateral and larger than the scrotal counterpart . The abdominal component has been described properitoneal, retroperitoneal and also between the two layers of the broad ligament; in our patient, it was mainly properitoneal but also expanded into the left retroperitoneum .…”

Hemorrhagic abdominoscrotal hydrocele. A challenging entity

“…It is also important to detect small ASHs with no palpable abdominal component, because the communication between the abdominal and the scrotal portions is in an hourglass fashion and lies deep within the internal inguinal ring [2,5]. This justifies to carrying out a US at least in the presence of a tense hydrocele; indeed, upward compression by a tense scrotal component with a pressure exceeding the intraperitoneal one in the presence of an obliterated processus vaginalis or partially obliterated with a valvelike effect is the most popular explanation for the development of the abdominal portion of ASH [2,4,7,9].…”