Abdominoscrotal hydrocele in an infant boy

Abstract

Abdominoscrotal hydrocele (ASH) is the rarest type of hydrocele. This condition is characterised by a large abdominal and scrotal component connected by an isthmus within the inguinal canal. The incidence among the paediatric population is reported to be less than 3%, although it might be underdiagnosed. Several theories have been proposed in the literature but the aetiology of ASH remains unknown. Diagnosis can be made clinically and confirmed by ultrasound. Spontaneous resolution is rare and long-standing ASH may lead to complications, thus early surgical intervention is recommended. Different techniques have been described, but dissection remains challenging due to the tunica vaginalis adherence to the testis and the distal cord. We present a male infant with ASH who underwent inguinal repair. The procedure was facilitated by needle decompression of the mass. Identification and preservation of the vessels and vas deferens was done successfully without compromising the testis.

A Rare Case of Bilateral Abdominoscrotal Hydrocoele in a 10-Month-Old Infant Managed Laparoscopically

“…Although first identified in 1777 by Parcival-Pott, it was not until 1834 that Dupuytren postulated an aetiological explanation for ASH [ 4 ]. In his opinion, ASH originates from a pre-existing testicular hydrocoele, which accumulates over time leading to a build-up of pressure, eventually displacing the fluid through the inguinal canal and into the abdominal cavity [ 2 , 3 ]. However, with time, more cases were reported, allowing for a better understanding of the physical principles involved in the development of the condition, and thus new aetiological theories soon emerged.…”

“…Identifying ASH as a diagnosis can, in many cases, be a challenge. Generally speaking, it should be suspected when a scrotal swelling is found in conjunction with an abdominal swelling that is localised around the area of the deep inguinal ring [ 2 ]. In the majority of cases, it presents unilaterally, with bilateral cases (as was the case in this report) presenting much less frequently [ 4 ].…”

“…Hydrocoeles can arise due to a variety of reasons in both the paediatric as well as the adult population, rendering a specific classification essential to differentiating the cause in each case and hence choosing appropriate management. Hydrocoeles can be classified into primary, secondary communicating, secondary non-communicating, congenital, and tumour-induced, with many other types and sub-types [ 1 , 2 ].…”

Giant Abdominoscrotal Hydrocele in Adult: A Rare Entity

“…It is the least common type of hydrocele. Despite several theories, the etiology remains unknown and further studies are needed to determine the exact cause [ 8 ].…”

A challenging abdomino-scrotal hydrocele—successful resolution with the help of interventional radiology guided sclerosis

“…Abdomino-scrotal hydroceles are rare, with a reported incidence of <3% in boys [ 3 – 5 ]. They are frequently diagnosed with USS and may be suspected if examination of the groin is atypical.…”