Topal Uğur, Sarıtaş Ahmet Gökhan, Ülkü Abdullah, Akçam Atılgan Tolga, Doran Figen
Çukurova University, Department of General Surgery, Adana, Turkey.
Çukurova University, Department of General Surgery, Adana, Turkey.
Int J Surg Case Rep. 2018;52:117-119. doi: 10.1016/j.ijscr.2018.09.053. Epub 2018 Oct 10.
Coley, in 1892, reported 14 cases of a hydrocele in women. He described this "affection" as being "too rare an anomaly to deserve consideration. The rarity of this finding continues to be described in more current literature of 400 cases.
42-year-old woman presented to the clinic with a palpable mass in her left inguinal region. On physical examination, a soft-consistency, mobile mass of about 4 cm in size was seen in the left inguinal region. The cystic lesion which was seen to be originated from the inguinal canal was excised in the exploration made by suspending the round ligament by passing through the anatomical folds with the incision made from the left inguinal region. The defect was repaired with prolene mesh after high ligation. Patient was discharged on the 1st postoperative day.
In women, a round ligament is attached to the uterus close to the origin of the fallopian tubes, and the extension of the parietal peritoneum follows the round ligament as it passes to the inguinal canal through the internal ring. Hydroceles of the canal of Nuck were not conclusively diagnosed until surgery was performed on a suspected inguinal hernia. The treatment of Nuck canale hydroceles are surgery. Ligating the prosessus vaginalis and excision of the cyst in surgical treatment will prevent recurrences.
Nuck canal cysts should be considered in the differential diagnosis of cases of female patient's complaints of swelling in the inguinal region.
1892年，科利报告了14例女性鞘膜积液病例。他将这种“病症”描述为“极为罕见的异常情况，不值得关注”。在更近期的400例文献中，这一发现的罕见性仍被提及。
一名42岁女性因左侧腹股沟区可触及肿块就诊于诊所。体格检查发现，左侧腹股沟区有一个质地柔软、可活动的肿块，大小约4厘米。在通过从左侧腹股沟区切开，穿过解剖褶皱悬吊圆韧带进行的探查中，切除了这个起源于腹股沟管的囊性病变。高位结扎后用聚丙烯网片修复缺损。患者术后第1天出院。
在女性中，圆韧带附着于子宫靠近输卵管起始处，壁腹膜的延伸随着圆韧带通过内环进入腹股沟管。直到对疑似腹股沟疝进行手术，努克管鞘膜积液才得以确诊。努克管鞘膜积液的治疗方法是手术。手术中结扎鞘突并切除囊肿可防止复发。
在女性患者腹股沟区肿胀主诉的病例鉴别诊断中应考虑努克管囊肿。
