Alhashim Aqeel, Almuslim Ahmed, Alhakeem Ruqaiyah, Aldossary Hamza, Alburaih Abdullah, Alsaleh Fatimah, Alkishi Tumadhir, Alhashim Ali
Department of Radiology, Almoosa Health Group, Al Mubarraz, Kingdom of Saudi Arabia.
Radiology, King Fahad Hospital of the University, Al Khobar, Kingdom of Saudi Arabia.
Radiol Case Rep. 2025 Jul 22;20(10):5070-5073. doi: 10.1016/j.radcr.2025.06.102. eCollection 2025 Oct.
A 7-year-old girl presented complaining of right groin swelling for 1 week and underwent routine examination at the emergency department. An ultrasonography reported a well-defined cystic lesion with no internal vascularity, connected to the inguinal canal, and located lateral to the epigastric vessels. Images were not conclusive, and surgical excision was performed 2 days later, with an uneventful postoperative recovery. Intraoperatively, the lesion was identified as an encysted hydrocele of the canal of Nuck. During female development, the parietal peritoneum descended along the round ligament of the uterus through the inguinal ring and into the inguinal canal, which is known as "canal of Nuck." The round ligament is attached to the uterine cornu adjacent to the origin of the fallopian tube and to the ipsilateral labia majora. If the processus vaginalis does not close and remain patent, this could lead to fluid to pass through and accumulate to form a communicating hydrocele, and the opening is large enough to allow abdominal organs to herniate. This will lead to another differential diagnosis of inguinal swelling, inguinal hernia . This case highlights the importance of considering this rare entity in the differential diagnosis of groin swellings in pediatric females and the role of imaging in guiding management.
一名7岁女孩因右侧腹股沟肿胀1周前来就诊，并在急诊科接受了常规检查。超声检查报告显示有一个边界清晰的囊性病变，内部无血管，与腹股沟管相连，位于腹壁血管外侧。图像结果不明确，两天后进行了手术切除，术后恢复顺利。术中发现该病变为努克管囊肿。在女性发育过程中，壁腹膜沿着子宫圆韧带通过腹股沟环下降至腹股沟管，此即所谓的“努克管”。圆韧带附着于输卵管起始处附近的子宫角及同侧大阴唇。若鞘突未闭合且保持开放，可导致液体通过并积聚形成交通性鞘膜积液，且开口足够大时可使腹腔脏器疝出。这会导致腹股沟肿胀的另一种鉴别诊断——腹股沟疝。该病例凸显了在小儿女性腹股沟肿胀的鉴别诊断中考虑这种罕见疾病的重要性以及影像学在指导治疗中的作用。
