Hindawi Publishing Corporation Case Reports in Urology Volume 2013, Article ID 275257, 3 pages http://dx.doi.org/10.1155/2013/275257 Case Report Infected Hydrocele of the Canal of Nuck Parkash Mandhan, 1,2 Zaid Raouf, 3 and Khalid Bhatti 3 1 Division of Paediatric Surgery, Department of Surgery, Sultan Qaboos University Hospital, 123 Muscat, Oman 2 Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar 3 Department of Surgery, Sultan Qaboos University Hospital, 123 Muscat, Oman Correspondence should be addressed to Parkash Mandhan; pmandhan@gmail.com Received 12 September 2013; Accepted 7 November 2013 Academic Editors: G. Kara Gedik, B. Rekhi, and F. Sanguedolce Copyright © 2013 Parkash Mandhan et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Hydrocele of the canal of Nuck in children is rare. It may present as incarcerated inguinal hernia and necessitates emergency exploration. Risk of infection in hydrocele of the canal of nuck is very rare. We present a case report of a 5-year-old girl who presented with a lef tender inguinolabial region swelling with fever, tachycardia, and mild dehydration. Te clinical features were suggestive of strangulated lef inguinal hernia and further imaging and surgical exploration revealed it to be an infected hydrocele of the canal of Nuck. High ligation and hydrocelectomy were performed. Hydrocele of the canal of Nuck in a female child presenting with an inguinal swelling should be considered in diferential diagnosis. 1. Introduction Contents of the inguinal canal vary between female and male population. During development, in the female fetus, round ligament of the uterus descends into the inguinal canal to the labium major. Te peritoneal fold that descends with the round ligament is named the canal of Nuck. If this communication fails to close, it results in an indirect hernia or a hydrocele [1]. Hydrocele of the canal of Nuck is not a common entity as only isolated case reports are published in the literature [1– 6]. Infection is an uncommon complication of hydroceles in children, and until now only 5 cases have been reported in the English language literature, all in boys [2, 7]. We present a case of infected hydrocele of the canal of Nuck in a 5-year-old girl, initially pictured as strangulated inguinal hernia and later diagnosed as a case of infected hydrocele of the canal of Nuck. We emphasize to consider this as a diferential diagnosis in girls with tender inguinolabial swelling. 2. Case Report A 5-year-old girl presented to the emergency with history of painful mass in the lef inguinolabial region noticed a week before presentation. Te child has a positive history of trivial trauma in school while playing with other children. Te inguinal swelling and pain got gradually worse over the week. Tere was no history of recent illness in near future. Exam- ination revealed temperature of 38 ∘ C, heart rate of 140/m, and mild dehydration. Abdominal and chest examinations were unremarkable. Local examination revealed a 6 × 3 cm irreducible tense swelling in the lef inguinolabial region, with overlying skin redness and edematous. Blood investigations revealed white blood cell count of 14000/mm 3 , C-reactive protein 50, normal electrolytes, and coagulation profle. Her urinalysis was normal. Blood culture and sensitivity was sent and was reported normal. An ultrasound of inguinal region performed in the emergency room revealed a cystic mass in lef inguinal region containing fuid in the upper part and fuid with internal echoes in the lower part of mass, and there was no free fuid noted in the abdomen. Afer resuscitation with fuids and administration of IV antibiotics, she was taken to the operating room for exploration. Operative fndings included a cystic mass in the lef inguinal canal extending down to the ipsilateral labia majora (Figure 1(a)), cyst con- taining dark brown fuid in the proximal part, and clotted blood with dark fuid in the distal part (Figure 1(b)). Te cystic swelling was confrmed to be an encysted hydrocele of canal of the Nuck with no evidence of associated inguinal