Abdominoscrotal Hydrocele in an Adult: The Rarest Form of Hydrocele

Abstract

Abdominoscrotal hydrocele (ASH) represents a rare condition characterized by abdominoscrotal cystic enlargement that exhibits hourglass-shaped, fluid-filled accumulation communicating with scrotal and abdominal components on contrast-enhanced computed tomography. We present the case of a 44-year-old patient who presented with swelling in the right scrotal and abdominal regions. Upon examination, a positive cross-fluctuation was observed between the right scrotal swelling and the abdominal swelling, raising suspicions of ASH, which was subsequently confirmed radiologically. The patient underwent a right-sided sac excision and sac ligation at the deep ring performed through a right inguinal approach and subsequently experienced a smooth and uncomplicated recovery during the postoperative period. Surgical repair is the most common management approach rather than conservative management, and the use of an inguinal method over other surgical methods facilitates a lower risk of inadvertent injury to adjacent anatomical structures.

Keywords: abdominal cyst; abdominoscrotal hydrocele; adult; hydrocele; inguinoscrotal hydrocele.

Figure 1. Contrast-enhanced computed tomography of the coronal section showing cystic abdominal swelling in continuity with the scrotal swelling (marked with yellow arrows).

Figure 2. Intraoperative image of the sac approached through an inguinal incision.