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Hydrocele of the canal of Nuck

Case contributed by Vitalii Rogalskyi
Diagnosis almost certain

Presentation

Female with painless left inguinal mass.

Patient Data

Age: 50 years
Gender: Female

Abdomen and pelvis

ct

CT of the abdomen and pelvis demonstrates a tubular fluid-filled structure in the left inguinal area, extending to the ipsilateral labia majora, with no solid enhanced component. No obvious connection with intestines. No lymphadenopathy.

Other organs appear unremarkable.

Annotated image

Hydrocele of the canal of Nuck (red arrow).

Case Discussion

This finding demonstrates typical features of a hydrocele of the canal of Nuck. It is a rare condition in females, caused by a failure of complete obliteration of the canal of Nuck. The canal of Nuck is an abnormal patent pouch of peritoneum extending anterior to the round ligament of the uterus into the labia majora.

The main differential diagnosis is an inguinal hernia but, in this case, you don't see a herniated bowel loop or other organs in this area.

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