Case Report zyxwvu J Clin Ultrasound 23:210-211, MarchiApril 1995 CCC 0091-2751/95/030210-02 zy 0 1995 by John Wiley zyxwv & Sons, Inc. zyxw Abdominoscrotal Hydrocele: Diagnosis by Sonography N. Subramania Sivam, MS,* N. Ananthakrishnan, MS,* Vikram Kate, MS,* and C. Daniala, MD? Unlike hydrocele of the tunica vaginalis testis, abdominoscrotal hydrocele (ASH) is very rare. There have been few reports of this condition since Dupuytren described it in 1834.’ There are very few reports about the use of ultrasound in the diagnosis of ASH and its complication^.^-^ We present one such patient. CASE REPORT A 53-year-old man was referred with a diagnosis of irreducible left groin swelling of 8 years’ dura- FIGURE 2. Ultrasonograph showing abdominal and scrotal compo- nents of the sac communicating through the internal ring. tion. Examination revealed a large, transillumi- nant, left, inguinoscrotal swelling and a cystic lower abdominal mass occupying the left iliac fossa and extending up to the umbilicus (Fig- ure 1). Ultrasonography revealed a large hydrocele sac extending into the abdomen and pelvis ante- rior to the bladder, and displacing it to the right (Figures 2 and 3). The kidneys were normal in size, and there was minimal dilatation of the left ureter. An extraperitoneal excision of the abdominal sac and eversion of the scrotal sac were performed through a single inguinoscrotal incision. The sac contained 3 L of straw-colored, clear fluid. The patient made an uneventful recovery. FIGURE 1. Clinical photograph of the abdominoscrotal swelling. From the Departments of *Surgery and tRadiodiagnosis, DISCUSSION Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India. For reprints contact N. Anan- thakrishnan. MS. DeDartment of Sureem. JIPMER HosDital. Abdominoscrotal hydrocele (ASH) can cause con- siderable diagnostic difficulties. The condition - Pondicherry’605006, india. can produce hydronephrosis by pressure on the 210 JOURNAL zyxw OF CLINICAL ULTRASOUND