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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
In girls, the analogous diverticulum of processus through the internal ring was first described by Anton Nuck in 1691 and is referred to as the canal of Nuck. Herniation down to the level of the labia majora and hydrocele formation may also occur, albeit with less frequency than boys (1 : 4).
Inguinal hernia
Published in Prem Puri, Newborn Surgery, 2017
Thambipillai Sri Paran, Prem Puri
Hydrocele of the cord or cyst of canal of Nuck is difficult to differentiate from incarcerated hernia. It may be possible to get above a hydrocoele and is nontender. Transillumination is not a reliable sign in infants, as bowel wall is very thin and is usually transilluminant. However, there will be no preceding history of reducible swelling reported by parents, and the child remains asymptomatic with no obvious signs of discomfort. Ultrasound is helpful in distinguishing this condition from an obstructed hernia.
Vulval Swellings
Published in Tony Hollingworth, Differential Diagnosis in Obstetrics and Gynaecology: An A-Z, 2015
Varicocoele of the vulva occurs mainly in pregnancy and can become worse with successive pregnancies. They give a typical varicose appearance in the labia majora, and the patient can become conscious of an uncomfortable swelling on standing. The veins seldom rupture during delivery. Varicocoele must be distinguished from an inguinal hernia extending into the labium majus and from a cyst of the canal of Nuck (the processus vaginalis, which has failed to become completely obliterated). Both of the latter tend to involve only the anterior parts of the labium majus, but all these conditions extend to the groin. Whereas a hernia is reducible as a rule, a cyst of the canal of Nuck is not. Inguinal hernias usually disappear as pregnancy progresses, but varicocoeles become worse. If a hernia contains bowel, it is resonant to percussion. A strangulated hernia will not be reducible, but the accompanying acute symptoms and the history should make the diagnosis clear.
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
Cyst of the canal of Nuck is a rare cause of the swellings occurring in the inguinal area in women. Homologous to the processus vaginalis in men, the canal of Nuck is a pocket-shaped evagination of the parietal peritoneum that follows the same path as the round ligament of the uterus in the inguinal ring. Normally, this canal obliterates at birth or early infant period and loses its connection with the peritoneal cavity, but sometimes it can remain patent. If it remains completely patent, it forms an avenue for an indirect inguinal hernia. Partial proximal obliteration with a patent distal portion causes a cyst of the canal of Nuck, which is also referred to as female hydrocele [1].