Inguinal swelling in a young lady: a case report

Abstract

Ultrasonography, specifically high-resolution ultrasound is considered as the first-line imaging modality for evaluation of groin pathology. Ultrasonography can accurately distinguish a mass lesion either it is solid, cystic or complex (both solid and cystic). Here we report an inguinal swelling of a young lady evaluated by ultrasonography. A 29-year-old female patient came to Institute of Nuclear Medicine and Allied Sciences (INMAS), Cumilla for ultrasound of right inguinal region with the complaints of right inguinal swelling and occasional pain for 02 months. The swelling was firm, non-tender, didn't disappear on lying position. She had no associated fever, nausea, vomiting. High-resolution ultrasonography was performed to evaluate the swelling and an elongated, thin-walled cystic lesion was seen with internal echoes, extending from deep inguinal ring to labia majora. Doppler study shows no vascularity within the lesion. No peristalsis or change of shape or change in fluid amount seen on valsalva and augmentation. Sonological findings suggest right sided encysted hydrocele of the canal of Nuck. The cystic lesion was completely surgically removed, and histopathological examination verified an encysted hydrocele of the canal of Nuck with a smooth postoperative recovery. She was released in stable condition and stayed asymptomatic during follow-up with no signs of recurrence. Hydrocele of the canal of Nuck is rare in middle aged patient. High-resolution ultrasound plays vital role to diagnose confidently and to differentiate other pathological differentials in inguinal swelling specially from inguinal hernia and inguinal lymphadenopathy.