International Surgery Journal | September 2019 | Vol 6 | Issue 9 Page 3415 International Surgery Journal Parikh AK et al. Int Surg J. 2019 Sep;6(9):3415-3417 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Case Report Hydrocele of canal of Nuck in an adult female: a case report Atish K. Parikh*, Girish D. Bakhshi, Deepak B. Gadekar, Kushagra Rahul, Kritika Garg INTRODUCTION A hydrocele of canal of Nuck is an unusual condition seen in young females. It is characterized by a painless cystic swelling in the inguinal and labia majora region, considered being analogous to an encysted hydrocele of the cord in males. 1,2 While it is commonly seen in pediatric age group, here we present a rare case in an adult female. CASE REPORT A 20 year old female presented to outpatient department with history of a swelling in the right inguinal region since 2 months following a history of minor trauma to the region. The swelling was associated with mild, dull aching pain and a history of increase in size on straining and coughing. The patient had no significant surgical or obstetric history. On examination, a 2×2 cms cystic swelling was noted in the right inguinal region (Figure 1). Swelling became less prominent on leg raising and appeared to be partially reducible. There was clinical dilemma regarding diagnosis as clinical findings on cough impulse were equivocal. Local ultrasonography was performed which showed the presence of a 2.7×2.3 cms anechoic cystic lesion at the superficial inguinal ring with no evidence of any solid component within. Based on clinical findings and ultrasound report a provisional diagnosis of hydrocele of canal of Nuck was made. The patient was posted for elective surgery under spinal anaesthesia. An incision was made 2 cm above and parallel to the right inguinal ligament, similar to that of an inguinal hernioplasty. Skin and subcutaneous tissue were opened in layers until the external oblique aponeurosis (EOA) was reached. EOA was split along the direction of fibers and the inguinal canal entered. A 2×2 cm cystic swelling was noted at the superficial inguinal ring (Figure 2). The round ligament was identified and by a combination of blunt and sharp dissection the swelling was isolated from it. After ensuring that there was no communication with the peritoneal cavity, the swelling was excised intact and sent for histopathological examination. The cut end of the round ligament was fixed to the pubic tubercle using 2-0 polyglactin sutures, and the posterior wall of inguinal canal plicated with 2-0 ABSTRACT A hydrocele of canal of Nuck is a rare condition seen in females, commonly in the pediatric age group. The canal of Nuck is an extension of peritoneum into the inguinal canal through the deep ring, analogous to the processus vaginalis in males. Incomplete proximal obliteration and collection of serous fluid in the sac leads to the formation of a hydrocele of canal of Nuck. Here we present a rare case of hydrocele of canal of Nuck in an adult female. Keywords: Female hydrocele, Canal of Nuck, Inguinal hernia Department of Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India Received: 18 June 2019 Accepted: 03 August 2019 *Correspondence: Dr. Atish K. Parikh, E-mail: atishparikh@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20194090