A Rare Case of Hydrocele of Canal of Nuck in an Adult Female

Abstract

Background: This case report discusses a rare case of Hydrocele of canal of Nuck in an adult female and its management by laparoscopic surgery. Presentation: A 35 year old female patient presented with gradually increasing swelling in the right groin since 2 months. On examination, a 5x4cm swelling was noted in the right inguinal region, soft in consistency with absent expansive cough impulse. Ultrasound showed a 6x4.5cm multilocular, anechoic cystic lesion with internal septations in the right inguinal region. Diagnostic laparoscopy was done and hydrocele of canal of nuck was confirmed on the right side. Excision and TAPP repair using 15x10cm polypropylene mesh was done. Discussion: During embryological development of a female foetus, the round ligament descents to the labia majora through the inguinal canal carrying along with it, a fold of parietal peritoneum called canal of Nuck. It is the female analogous to the processus vaginalis in males and normally gets obliterated by the first year of life. Failure to do so may result in a hydrocele or a hernia. Conclusion: Hydrocele of canal of Nuck is a rarely diagnosed condition in adult females often mistaken for inguinal hernia and other cystic lesions. Surgical excision is both diagnostic and therapeutic in providing relief and preventing recurrence. It should be a differential diagnosis for inguino-labial or inguinal swelling in an adult female.