ABSTRACT
Abdominoscrotal hydrocele (ASH) is very rare in adults and difficult to suspect on clinical examination. ASH is a very unusual presentation of scrotal hydrocele with extension intra-abdominally through the inguinal canal either communicating to the peritoneal cavity or non-communicating. An ASH is a congenital pathology involving a scrotal hydrocele expanding through the inguinal canal and reaching the abdominal cavity. Here, we present the case of a 25-year-old man admitted with a complaint of pain and lump in the left lower abdomen for 2 months and swelling in the left groin for 2 years. Ultrasound and computed tomography suggest left ASH with left-sided hydroureteronephrosis. A left DJ stent was placed and on exploration, a large cystic mass was seen intraperitoneally extending into the scrotum through the inguinal canal. Excision of the abdominal part and partial excision of the scrotal part were done with eversion of the remaining tunica vaginalis sac. Although ASH is a rare entity, it should always be kept on the list of differential diagnoses during the complaint of large abdominal mass in adults.
ABSTRACT
【Objective】 To evaluate the feasibility and safety of laparoscopic partial excision of the cyst wall combined with internal inguinal ring repair in the treatment of pediatric abdominoscrotal hydrocele (ASH). 【Methods】 Clinical data of 12 ASH children treated during Mar.2017 to May 2020 were retrospectively analyzed, including clinical manifestations, preoperative diagnosis, intraoperative findings, and postoperative results. 【Results】 A preoperative diagnosis of ASH was made in 9 cases. In the other 3 cases, ASH was detected during laparoscopic repair of the hydrocele. The opening of the internal inguinal ring was wide and cavernous, and patent processus vaginalis (PPV)was detectedin all cases. Contralateral pathologies were detected in 5 cases, including hydrocele in 4 and inguinal hernia in 1. All patients received laparoscopic partial excision of the cyst wall combined with internal inguinal ring repair. During the follow-up of 6-37 months, no recurrence of ASH or ipsilateral hernias occurred, and no testicular atrophy was observed. 【Conclusion】 Laparoscopic partial excision of the cyst wall combined with internal inguinal ring repair is effective, safe and feasible in the treatment of the pediatric ASH.
ABSTRACT
Abdominoscrotal hydrocele is rare in clinic. In the past, routine examination and diagnosis were difficult, easy to be misdiagnosed. The daily operations were mostly completed through the groin area or abdominal incision, the wound is large. The application of laparoscopy can clearly diagnose the abdominoscrotal hydrocele through "springing back ball" sign, and can cure the disease by laparoscopic resection of interperitoneal mass and closure of the internal ring. It is worthy of clinical application. In this article, we summarized and analyzed the clinical experience of 15 cases of children with abdominoscrotal hydrocele diagnosed and treated by laparoscopy, to explore the value of the laparoscopic technology in the diagnosis and treatment of the abdominoscrotal hydrocele.