Unit of Pediatric Surgery, Department of Women, Children, General and Specialist Surgery, Luigi Vanvitelli University of Campania, Naples, Italy -
Unit of Pediatric Surgery, Department of Women, Children, General and Specialist Surgery, Luigi Vanvitelli University of Campania, Naples, Italy.
Minerva Pediatr (Torino). 2021 Apr;73(2):180-183. doi: 10.23736/S2724-5276.18.05205-2. Epub 2018 Jul 23.
Inguinal and/or inguino-scrotal swellings, such as hernia and hydrocele, are among the commonest anomalies in childhood. Hydrocele of the canal of Nuck is an uncommon diagnosis and a rare cause of swelling in women that occurs due to a patent vaginal process.
From January 2001 to January 2016, 353 female patients 1-14 years of age were admitted to our university hospital division for inguinal swelling. We have performed 403 inguinal approaches, and of these, 399 (99%) had inguinal hernias, 3 (0.74%) had a cyst of the canal of Nuck, and 1 (0.24%) had a lipoma. All of the patients with Nuck cysts underwent surgical exploration of the swelling through a right inguinal skin crease incision.
The patients were between the ages of 1 and 8 years. The cyst sizes varied between 25 and 40 mm. All the patients exhibited right, tender, painless, non-reducible masses. In all patients, ultrasound confirmed the suspected diagnosis. The histological findings revealed fibrous-walled cystic formations with mild chronic inflammatory infiltrate that were covered by mesothelial epithelium. The patients' postoperative follow-ups at 1, 6 and 12 months revealed normally healed incisions with no recurrences.
The surgical findings and the histological demonstrations of serous epithelium seemed to validate the hypothesis that the patency of the inguinal canal combined with fluid secretion of the peritoneal serosa participated in the formation of the cysts. Surgery with high ligature of the vaginal process is considered the therapy of choice for this pathology.
腹股沟和/或腹股沟-阴囊肿胀，如疝和鞘膜积液，是儿童中最常见的异常之一。努克管鞘膜积液是一种不常见的诊断，也是女性肿胀的罕见原因，其发生是由于阴道过程的通畅。
从 2001 年 1 月至 2016 年 1 月，353 名 1-14 岁的女性患者因腹股沟肿胀而入住我们的大学医院分部。我们进行了 403 例腹股沟入路手术，其中 399 例（99%）为腹股沟疝，3 例（0.74%）为努克管囊肿，1 例（0.24%）为脂肪瘤。所有努克囊肿患者均通过右腹股沟皮皱切口对肿胀进行手术探查。
患者年龄在 1 至 8 岁之间。囊肿大小在 25 至 40 毫米之间。所有患者均表现为右侧、触痛、无痛、不可还原的肿块。所有患者的超声均证实了可疑诊断。组织学检查显示纤维壁囊性形成，伴有轻度慢性炎症浸润，由间皮上皮覆盖。所有患者的术后 1、6 和 12 个月随访均显示切口愈合正常，无复发。
手术发现和浆膜上皮的组织学表现似乎验证了这样一种假说，即腹股沟管的通畅性加上腹膜浆膜的液体分泌参与了囊肿的形成。对于这种病理，高结扎阴道过程的手术被认为是首选治疗方法。
