背景:在成年女性中,Nuck运河鞘膜积液(HCN)是一种非常罕见的疾病。大多数报告的HCN病例直到对疑似腹股沟疝进行手术才被最终诊断出来。据我们所知,这是中东和北非地区成年女性腹腔镜手术HCN的首例,这是全球第四起此类案件。
方法:一名36岁女性患者右侧腹股沟出现疼痛小肿胀,持续3个月。站立时肿胀延伸到右阴唇,当病人处于俯卧位时消失了.没有淋巴结肿大,腹部没有其他肿块,对侧没有肿胀。对患者进行了超声检查,并选择性地接受了非复杂性右腹股沟疝的腹腔镜探查和修复。已知她在药物治疗时患有血脂异常。进一步的病史和体格检查无明显变化。术中诊断为右侧HCN,经腹腹膜前(TAPP)入路通过网片固定切除并修复。她的后续课程并不引人注目。
结论:该病例扩大了成年女性腹股沟肿块的临床和术中潜在鉴别诊断。外科医生在术中观察到这种肿胀时应考虑这种情况。在这种情况下,腹腔镜TAPP方法是一种优越的诊断和治疗方式。
BACKGROUND: Among adult females, Hydrocele of Canal of Nuck (HCN) is a very rare condition. The majority of the reported cases of HCN were not conclusively diagnosed until surgery was performed on a suspected inguinal hernia. To the best of our knowledge, this is the first case of laparoscopically operated HCN in adult female in Middle East and North Africa Region, and the fourth such case worldwide.
METHODS: A 36-year-old female presented with a painful small swelling in the right groin of 3 months duration. The swelling extended to the right labia majora while standing, and disappeared when the patient was in prone position. There was no lymph node enlargement, no other masses in the abdomen, and no swelling in the contralateral side. Ultrasonography was undertaken and the patient was admitted electively for laparoscopic exploration and repair of non-complicated right inguinal hernia. She was known to have dyslipidemia on medications. Further history and physical examination were unremarkable. Intraoperatively it was diagnosed to be right-sided HCN which was excised and repaired by mesh fixation using transabdominal preperitoneal (TAPP) approach. Her follow up course was unremarkable.
CONCLUSIONS: This case expands the clinical and intraoperative potential differential diagnosis of adult female groin masses. Surgeons should consider such cases when they observe such swellings intraoperatively. Laparoscopic TAPP approach in such cases is a superior diagnostic and treatment modality.