Hydrocele of the canal of Nuck

Case contributed by Dr Erik Ranschaert

Presentation

Painful palpable mass in the left inguinal region and reddish swelling of the labium majus

Patient Data

Age: 3 years
Gender: Female
MRI

The T1-images show a rather thick-walled blind ending comma-shaped hypointense mass in the left inguinal area, with a blunt ending distally and extending into the peritoneal cavity proximally along the route of the round ligament.
The T2-images show mixed cystic content of the inguinal mass, it does not appear purely cystic.
The hydrocele is extending towards the labium majus. The post-contrast acquisition demonstrates mild enhancement of the wall of the hydrocele.

Case Discussion

Infected hydrocele of the canal of Nuck. A hydrocele is the result of a failed obliteration of the inguinal part of the processus vaginalis (so-called canal of Nuck).

The surgeon decided to treat conservatively with antibiotics, and the swelling gradually decreased. Follow-up after 1 year showed complete resorption of the hydrocele.

Superadded infection of the hydrocele is most likely the cause of the wall thickening and enhancement in this case; in most cases, hydroceles have thin walls. The hydrocele does not look purely cystic on the T2-images, this might be due to some intraluminal debris caused by the infection.

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Case information

rID: 11073
Published: 14th Oct 2010
Last edited: 13th Aug 2019
Inclusion in quiz mode: Included

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