Hydrocoele of the canal of Nuck

Case contributed by Dr Craig Hacking

Presentation

Abdo pain. Noted to have non tender right groin lump.

Patient Data

Age: 40-45 years
Gender: Female
Ultrasound

Medial to the right femoral vein is a hypoechoic, well-defined structure measuring up to 20mm and not altering in appearance on valsalva manoeuve. This lesion was non-tender to sonopalpation. There is no evidence of bowel within this lesion. It does not distort the femoral vein. No femoral or inguinal hernia detected.

Conclusion

The appearance is highly suggestive of a hydrocoele of the canal of Nuck.

The liver, spleen, pancreas and adrenals have a normal appearance. There is a low attenuating ovoid area within cortex of the midpole of the right kidney. This measures 34 x 14 mm (HU 35) and is atypical for a cyst. The kidneys are otherwise normal. No abdominal or pelvic lymphadenopathy identified. No free gas, no abdominal or pelvic collection evident.

In the right groin is a 21 x 13 mm fluid density structure anterior and medial to the common femoral vein. It has a thin tail extending to the expected location of the superficial inguinal ring.

The appendix is not clearly defined however no indirect evidence of appendicitis. No obvious diverticular disease. The large and small bowel have been more calibre and gas pattern. No evidence of obstruction. Within the pelvis there is a large fibroid uterus. Within the fundus of the uterus there is a 40 mm well defined slightly heterogeneous fibroid. The internal features are of low density and may be consistent with a recent internal haemorrhage.

Conclusion

No obvious diverticulitis or features of appendicitis. Large fibroid uterus with heterogeneous fundal fibroid suggestive of recent internal bleed.

Right canal of Nuck hydrocoele.

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Case information

rID: 40908
Case created: 7th Nov 2015
Last edited: 18th Aug 2017
Inclusion in quiz mode: Included

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