Kohata Akihiro, Hirata Yuzo, Ishikawa Sho, Kai Azusa, Namba Yosuke, Okimoto Sho, Mukai Shoichiro, Fujisaki Seiji, Takahashi Mamoru, Fukuda Toshikatsu, Nishida Toshihiro
Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University Hospital, Hiroshima, Japan.
Department of Surgery, Saiseikai Hiroshima Hospital, Hiroshima, Japan.
J Surg Case Rep. 2020 Aug 25;2020(8):rjaa222. doi: 10.1093/jscr/rjaa222. eCollection 2020 Aug.
A 49-year-old woman presented to the hospital with a right inguinal swelling. On examination, we suspected hydrocele of the canal of Nuck (HCN) or an appendiceal or retroperitoneal tumor. Surgery for diagnosis and removal of the mass revealed that it was large and located in the preperitoneal cavity, extending into the inguinal ring; so, it was difficult to observe the entire outline of the mass solely using the laparoscopic approach. Therefore, we added the conventional approach with an inguinal incision. This combination of conventional and laparoscopic approaches helped in safe removal of the tumor. The HCN is an unusual developmental condition in women among whom it might cause an inguinal swelling infrequently. In a case with a large HCN, a combined approach using conventional and laparoscopic methods is suggested for better observation of the abdomen and successful resection without perforation of the mass than when using a single approach.
一名49岁女性因右侧腹股沟肿胀入院。检查时，我们怀疑是努克管水囊肿（HCN）或阑尾或腹膜后肿瘤。为诊断和切除肿块进行的手术显示，肿块很大，位于腹膜前腔，延伸至腹股沟环；因此，仅用腹腔镜方法很难观察到肿块的全貌。所以，我们增加了腹股沟切口的传统方法。传统方法与腹腔镜方法相结合有助于安全切除肿瘤。HCN在女性中是一种不常见的发育异常情况，可能很少导致腹股沟肿胀。对于大的HCN病例，建议采用传统方法与腹腔镜方法相结合，以便更好地观察腹部，并比单一方法更成功地切除肿块而不发生肿块穿孔。
