Egbuchulem K I, Akinboyewa B A, Onwurah C O
Division of Paediatric Surgery, Department of Surgery, University College Hospital, Ibadan.
Department of Anaesthesia, University College Hospital, Ibadan.
Ann Ib Postgrad Med. 2023 Aug;21(2):90-93. Epub 2023 Nov 1.
The surgical condition termed hydrocoele of the canal of Nuck is one of the rarest clinical entities in the female group. It occurs due to the failure of obliteration of the derivative of the peritoneum, the processus vaginalis. It usually presents with painless inguinal swellings and is sometimes associated with features of intestinal obstruction if there is hernia coexisting with it that has become obstructed. Abdominopelvic ultrasonography and magnetic resonance imaging provide the basis for diagnosis, where these imaging modalities are available. However, a definite diagnosis may only be made during surgery. Definitive treatment includes groin exploration and excision of the cyst with high ligation of the neck of the sac up to the peritoneal pouch, along with repair of the inguinal hernia, if present.
We present a rare case of a 34-year-old woman who presented with clinical features of a left inguinolabial swelling post-surgery, and diagnosed as left recurrent irreducible inguinal hernia. Intraoperatively, a cystic swelling with serous collection was observed. She had hydrocoelectomy and repair of the left groin surgical wound.
Hydrocoele of the canal of Nuck may be misdiagnosed as inguinal hernia because of its rarity, lack of adequate knowledge regarding the entity and paucity of literature on the subject matter. This report is to furthermore increase our level of awareness of this condition especially after a previous groin surgery.
努克管水囊肿这一外科病症是女性群体中极为罕见的临床病症之一。它是由于腹膜衍生物鞘突未闭所致。通常表现为无痛性腹股沟肿胀,若同时存在疝且发生梗阻,则有时会伴有肠梗阻的特征。在有腹部盆腔超声和磁共振成像设备的情况下,这些成像方式为诊断提供依据。然而,只有在手术过程中才能做出明确诊断。确切的治疗方法包括腹股沟探查,切除囊肿并高位结扎囊颈直至腹膜袋,若存在腹股沟疝则同时进行修补。
我们报告一例罕见病例,一名34岁女性术后出现左侧腹股沟阴唇肿胀的临床特征,被诊断为左侧复发性不可复性腹股沟疝。术中观察到一个有浆液积聚的囊性肿胀。她接受了努克管水囊肿切除术并修复了左侧腹股沟手术伤口。
由于努克管水囊肿罕见,对该病症缺乏足够了解且相关文献较少,它可能被误诊为腹股沟疝。本报告旨在进一步提高我们对这种病症的认识,尤其是在既往有腹股沟手术史之后。