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Gastrointestinal and genitourinary systems
Published in Helen Butler, Neel Sharma, Tiago Villanueva, Student Success in Anatomy - SBAs and EMQs, 2022
4 Which of the following statements regarding the inguinal canal is correct? Its contents include the round ligament in women.The ilioinguinal nerve enters the canal via the deep ring.Abdominal contents herniating through the deep ring form a direct inguinal hernia.The inguinal canal is only present in males.The deep ring lies medial to the superficial inguinal ring.
Inguinal hernia, hydrocele, and other hernias of the abdominal wall
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Sophia Abdulhai, Todd A. Ponsky
A transverse incision is made in the lowest inguinal skin crease above the external inguinal ring on the affected side (Figure 24.2). Be aware of the superficial epigastric vein here to avoid bleeding. Scarpa's fascia is incised and the external oblique aponeurosis is identified. This is exposed and traced inferiorly to the inguinal ligament and medially to expose the decussating external (superficial) inguinal ring enveloping the emerging spermatic cord. This technique minimizes the risk of opening the inguinal canal too medially.
Testicular Cancer
Published in Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed, MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Nkwam Nkwam, Chitranjan J. Shukla, David A. Manson-Bahr, Taimur T. Shah, Farooq Khan
Regarding orchidectomy for testicular cancer, which of the following is TRUE?Testicular prosthesis can be inserted without fear of prohibitive infectious complications.Division of the spermatic cord must be taken at the superficial inguinal ring.In cases of symptomatic metastatic disease orchidectomy should precede chemotherapy.Organ-sparing surgery can be performed when tumour volume is less than 50%.Long-term risk of silicone implants is well known.
Image of the month: cyst of the canal of Nuck
Published in Acta Chirurgica Belgica, 2018
Banu Karapolat, Hatice Ayça Ata Korkmaz, Gulgun Kocak, Eser Bulut
Being a rare developmental disorder, cyst of the canal of Nuck is seen mainly in adolescence in women and appears as a mass generally not exceeding 3 cm, localized in the inguino-labial region; it is painless, relatively hard, irreducible in the abdominal cavity and not growing with a valsalva maneuver [2]. In cases with a cyst large enough in size, a translumination test shows no other texture except for the fluid in it. It is difficult to make a diagnosis based solely on anamnesis and physical examination in such cases. Imaging techniques such as high-resolution ultrasound scan or magnetic resonance (MR) imaging can help the clinician to make a diagnosis in the preoperative period. In an ultrasound scan, a cyst of canal of Nuck appears as an anechoic or hypoechoic unilocular lesion extending to the surface in the shape of a sausage or comma in the pubic tubercule and the medial part of the groin at the level of the superficial inguinal ring and ultrasound scan is a highly accurate imaging modality. An MR scan is useful in complicated cases, particularly in those involving additional pathologies and it appears as a well-defined, thin-walled cystic lesion in hypointense on T1-weighted and hyperintense on T2-weighted series [1]. Additionally, an MR scan shows very well the anatomic structures surrounding the cyst, communication between the cyst and the peritoneal cavity, and the extension of the cyst of the canal of Nuck, which allows for successful surgical planning and excision [3]. Indirect inguinal or femoral hernia, tumors such as lipoma, leiomyoma or sarcoma; abscess, lymphadenopathy, hematoma, vascular anomalies, and ganglion cysts should be considered in differential diagnosis [4]. The final diagnosis is established through surgical exploration and histopathological examination of the removed specimen. Complete excision of the cyst and high ligation of the open neck of processus vaginalis are sufficient for treatment.