Hydrocele of the Canal of Nuck: A Review

Abstract

Canal of Nuck abnormality is a rare surgical condition. The pathologies are mostly encountered in young girls, less than five years of age. The incidence is even less in adults. Various pathologic conditions related to the failure of processus vaginalis obliteration can occur, involving herniation of intraabdominal structures including intestinal and genital contents such as the uterus, fallopian tube, and ovary and hydrocele of the canal of Nuck. According to its rarity, hydrocele of canal of Nuck is often misdiagnosed for common groin masses. This review summarizes and simplifies embryology, the pathophysiology of the canal of Nuck abnormalities, imaging findings, and treatment options with emphasis on the hydrocele.

Keywords: hernia; hydrocele; hydrocele of the canal of nuck; inguinal mass; the canal of nuck.

Figure 1. Embryology during the third month of gestation

Illustration created by the authors.

Figure 2. Embryology during the fourth month of gestation

Illustration created by the authors.

Figure 3. Ultrasound of authors' patient shows echogenicity with a posterior acoustic enhancement of hydrocele of the canal of Nuck

Figure 4. Plain axial CT scan of authors' patient shows comma-shaped hydrocele that contains fluid attenuation (arrow)

Figure 5. Coronal CT scan of authors' patient in venous phase shows the proximal origin of hydrocele of the canal of Nuck (yellow arrow) lateral to inferior epigastric vessels (white arrow)

Figure 6. Intraoperative picture by the authors - a hydrocele of the canal of Nuck (two arrows). The round ligament was encircled (one arrow).

Figure 7. Intraoperative picture of a hydrocele of the canal of Nuck taken by the authors. This picture shows the obliteration of proximal processus vaginalis (arrow).