Srinivasan Rohit, Drage Martin, Olsburgh Jonathon
Department of Nephrology, Transplantation and Urology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
J Surg Case Rep. 2017 Oct 19;2017(10):rjx203. doi: 10.1093/jscr/rjx203. eCollection 2017 Oct.
Abdomino-scrotal hydrocele (ASH) is a very rare clinical entity. It is an unusual condition, in which there is an hourglass communication between a large hydrocele and the retroperitoneal space, through the inguinal canal. First described by Dupuytren in 1834 and defined by Bickle in 1919, the condition is rarely seen. Surgical management usually involves excision of the sac as the definitive treatment option. The pathogenesis of ASH remains unclear and numerous theories have been postulated. We favour the term scrotal-inguino-retroperitoneal (SIR) hydrocele as a more accurate description. The paper presents a unique case of a 24-year-old gentleman, with a functioning kidney transplant, who developed a large ASH/SIR hydrocele that required a midline laparotomy to fenestrate the sac.
腹阴囊鞘膜积液（ASH）是一种非常罕见的临床病症。它是一种不寻常的情况，即一个大的鞘膜积液与腹膜后间隙通过腹股沟管形成沙漏样连通。该病症由迪皮特朗于1834年首次描述，并由比克尔于1919年定义，临床罕见。手术治疗通常包括切除囊袋作为最终治疗选择。ASH的发病机制仍不清楚，已有多种理论提出。我们更倾向于使用阴囊-腹股沟-腹膜后（SIR）鞘膜积液这一术语，认为它描述得更准确。本文介绍了一例独特病例，患者为一名24岁的男性，有一个功能正常的肾移植，他患上了一个巨大的ASH/SIR鞘膜积液，需要通过中线剖腹术对囊袋进行开窗引流。
