Canal of Nuck hydrocele

Abstract

The canal of Nuck describes a rare defect of the female inguinal canal that predisposes to the development of hernias or hydroceles. We present the case of a 12-month-old girl with a right inguinal mass representing a hydrocele of the canal of Nuck and review the reported cases in the literature to characterize the typical presentation of this uncommon pathology. We performed a systematic review of the literature to identify reports of canal of Nuck hydroceles in females age 13 years and below. Data on presenting symptoms, workup, and treatment were analyzed. The review identified a total of 105 cases dating back to the 1890s. Incidence was progressively less common with age. The hydroceles were mostly right-sided (66%), nontender (75%), non-reducible (88%), mobile (86%), and transilluminating (89%). Ultrasound featured in most workups, and MRI was occasionally used. Only 60% of reports mentioning preoperative differential diagnoses indicated suspicion for hydrocele. Open surgical excision is the standard treatment approach. Canal of Nuck hydrocele is a rare pathology that should be on the differential diagnosis for a girl with an inguinal mass. Understanding the typical presentation will help clinicians achieve an accurate diagnosis.