Abdomino-Inguino-Scrotal Hydrocele (Ten-Hydroceles with Intraabdominal Extension) (original) (raw)
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Bilateral abdominoscrotal hydrocele in childhood
Srpski arhiv za celokupno lekarstvo
Introduction. Bilateral abdominoscrotal hydrocele is a rare entity in childhood. The etiology of abdominoscrotal hydrocele has not been fully clarified. The diagnosis is based on clinical examination, ultrasound and magnetic resonance imaging. The treatment is surgery. Case outline. This paper presents an eight-month-old boy who was admitted at the department of pediatric surgery due to bilateral swellings in the scrotum area. The changes were first noticed when he was three months old and the diagnosis of bilateral abdominoscrotal hydrocele was confirmed after the scrotum ultrasound examination. When the patient was six and eight months old, the symptoms have significantly increased, the magnetic resonance of the abdomen and the lesser pelvis was performed, and the bilateral abdominoscrotal hydrocele was successfully treated with inguinal surgery. The operative and postoperative course was uneventful. Conclusion. In this paper, we presented a rare form of hydrocele in children, as ...
Abdominoscrotal hydrocele in childhood: is it really a rare entity?
Urology, 2000
Objectives. Abdominoscrotal hydrocele (ASH) is an apparently highly uncommon clinical entity especially in childhood, with only about 80 pediatric cases reported in the modern literature. Methods. The incidence, diagnosis, and treatment of ASH are discussed with reference to 9 cases observed at our institution and to cases in the literature. Results. Surgical correction was successful in all our cases and no hydrocele or hernia recurrence was registered. Conclusions. ASH incidence appears to be higher than reported; undescended testis is a frequent association and surgical correction through an inguinal approach is always possible and curative. Ligation of the processus vaginalis may prevent recurrence.
A case of bilateral abdominoscrotal hydroceles without communication with the peritoneum
Indian Journal of Urology, 2010
A 3-month-old boy was referred with a history of bilateral scrotal hydroceles since birth. On physical examination, large inguinoscrotal hydroceles were noted on both sides. After a 3-month period of observation, ultrasonography (US) showed extension of the bilateral hydroceles through the inguinal canal into the abdomen. Magnetic resonance imaging (MRI) confi rmed the US fi ndings [ ]. Surgical repair was scheduled for 2 months later. Laparoscopy was performed through an infraumbilical incision before hydrocelectomies. No patent processus vaginalis was found on either side. The abdominal cavity was compressed extraperitoneally by the abdominal component of the right ASH [ ]. Subsequently, bilateral hydrocelectomies were performed through ABSTRACT Abdominoscrotal hydrocele (ASH) is an uncommon entity. Although various theories on the development of ASH have been proposed, its etiology is still unclear. According to several etiological theories, it is necessary that ASH have communication with the peritoneum. We present a case of bilateral ASH that had no communication with the peritoneum.
Bilateral giant abdominoscrotal hydroceles in childhood
Urology, 1996
There is a paucity of cases in the literature describing the abdominoscrotal hydrocele (ASH). We report the diagnostic and therapeutic aspects of a rapidly expanding giant bilateral ASH in a 4-month-old boy. UROLOGY ® 47: 763-765, 1996. R eports describing examples of giant abdominoscrotal hydroceles (ASHs) in children are few. It was Dupytren in 1834 who first described this conditionl; however, it was not until 1919 that this entity received its present name-ASH. 2 Although this type of hydrocele has been known for more than a century, less than 20 cases have been reported in children. 3 In fact, it was not until 1988 that the first bilateral ASH was reported in a child. 4 CASE REPORT A 4-month-old, otherwise healthy, male infant was referred for evaluation of a congenital scrotal swelling. On physical examination, a large left inguinal scrotal hydrocele and a moderately sized right scrotal hydrocele were noted. The patient was then seen again at 7 months of age, and the left hydrocele was appreciably larger. The abdominal examination was unremarkable at this time, and no voiding abnormalities were present. Surgical repair was therefore scheduled due to the significant enlargement. Six weeks later at the time of anesthesia induction, a large abdominal mass was noted that extended 2 cm above the umbilicus (Fig. 1). This mass had not been present previously and did not reduce on insertion of a bladder catheter. Cystoscopy and a cystogram were performed. Normal bladder mucosa and a normal trigone were found; however, there was a left lower quadrant mass indenting the bladder. An ultra-From the
NON-INTERCOMMUNICATING ABDOMINOSCROTAL HYDROCELE WITH MULTI-SYSTEM ANOMALIES: A CASE REPORT
International Journal of Current Research and Review, 2017
Aim: Presentation of an abdominoscrotal hydrocele case with a very rare association to multiple anomalies and separate abdominal and inguinoscrotal sacs. Case Report: A 21-year-old male patient presented with left-sided abdominoscrotal hydrocele, impalpable right testis, hydro-cephalus and cerebral and musculoskeletal deformities. On abdominal ultrasonography, the abdominal and inguinoscrotal components were seen separated by a septum that was confirmed on surgery. Extended inguinal incision was used for repair and the post-operative course was uneventful. Discussion: Abdominoscrotal hydrocele is a rare entity and its simultaneous association to multiple anomalies, like in the current case, is a rarer finding. Non-intercommunication state is another very rare criteria of abdominoscrotal hydrocele which was clinically, sonographically and surgically demonstrated in this case. Extended inguinal incision was indicated and enough to deal with both abdominal and scrotal components. Conclusion: Abdominoscrotal hydrocele is mostly intercommunicating, but it is exceptionally non-intercommunicating and associated to multiple anomalies. Surgical excision via an extended inguinal incision may be indicated for voluminous cases and those with a solitary testis.
Urology, 2010
To introduce a modified trans-scrotal approach for treatment of abdominoscrotal hydrocele (ASH) in children. The postoperative outcomes are reviewed with long-term follow-up.We described a series of 7 boys (mean age, 23.4 months) who underwent surgical repair of ASH. The diagnosis was made based on physical examination, which revealed a tense hydrocele in association with ipsilateral cystic abdominal mass, confirmed by ultrasonography. After exposing the hydrocele sac through a scrotal incision, tunica vaginalis was opened and marsupialization of the hydrocele along with undermined dartos muscle layer was performed. Follow-up ranged from 9-12 months (average, 10.7 months).Overall, 10 ASH units (including 3 bilateral) were repaired. All of the affected testicles except one showed some degree of dysmorphism, according to ultrasonography or intraoperative findings, which resolved in all patients 3 months after surgery. There were no early postoperative complications except a mild scrotal edema. Neither recurrences of ASH nor testicular atrophy was observed.The diagnosis of ASH should be considered in a boy with hydrocele and concomitant abdominal mass, and can be established by ultrasonographic evaluation. Our experiment suggests that the modified trans-scrotal surgical method for management of ASH is reliable and effective with definite advantages. The high success rate, no extensive dissection of the inguinal canal, or complete excision of the sac, along with safety and simplicity of the procedure and short hospital stay, are important preconditions for the introduction of this method as a valid option for treatment of ASH.
Scrotal approach for the correction of an abdominoscrotal hydrocele: Medium term follow-up
Pediatric Urology Case Reports, 2015
Describe the scrotal surgical approach for abdominoscrotal hydrocele (ASH) with preservation of testicular function with midterm follow-up. Two patients diagnosed with ASH and contralateral testicular abnormalities. Both had scrotal correction for ASH, one had contralateral testicular neonatal torsion and the other contralateral communicating hydrocele. Four-year follow-up no complications or recurrence, and normal Anti-Mullerian hormone level. This pathology is a clinical diagnosis and it is treated with surgery via a scrotal approach, preventing sequels, contralateral complications and preservation of testicular function.
Large abdominoscrotal Hydrocele: Uncommon surgical entity
International Journal of Surgery Case Reports, 2015
INTRODUCTION: An abdominoscrotal hydrocele (ASH) consists of a large inguinoscrotal hydrocele which communicates in an hour glass fashion with a large "intraabdominal component". Mostly affects single testis but very rarely can present bilaterally. PRESENTATION OF CASE: We are presenting here a young 25 year old patient with large right sided scrotal swelling encroaching over lower abdomen. Clinically it was abdominoscrotal hydrocele which was confirmed with CT abdomen and later on subjected for surgery. DISCUSSION: Abdominoscrotal hydrocele is rarest type of hydrocele; first described by Dupuytren. The etiology of ASH is unknown; however, different theories have been described in literature to explain the pathogenesis. Diagnosis of ASH is done by clinical examination and is confirmed by radiological examination. Though ultrasonography is the first choice, in few selected cases contrast enhanced computerized tomography or magnetic resonant imaging may be helpful for more anatomical delineation. It may present with various complications secondary to pressure exerted by the components of the ASH. Surgical excision of the sac is the only definitive treatment option. There is no role of conservative treatment. Sometimes, decompression of the cyst needed to ease the dissection of the sac. CONCLUSION: Abdominoscrotal hydrocele differential should be considered while dealing with large lower abdominal swelling along with scrotal swelling.
Hydrocele in the Pediatric Patient: Inguinal or Scrotal Approach?
The Journal of Urology, 2008
The recommended approach for repairing hydrocele in children is inguinal to address a patent processus vaginalis. Hydrocele repair in adults is performed with a scrotal incision. We identified an age above which a significant percent of children had noncommunicating hydroceles, justifying a scrotal approach. Materials and Methods: A retrospective chart review was performed of children undergoing hydrocele repair at our institution between 1998 and 2006. Operative reports were reviewed by 2 investigators and intraoperative findings were recorded for statistical analysis relating age and findings at the time of the procedure using logistic regression and ROC analysis. Laterality and recurrence rates were also noted. Results: In this retrospective chart review 82.1% of hydroceles in children older than 10 years had intraoperative findings consistent with noncommunicating hydrocele and 86.4% in children older than 12 years were noncommunicating. One hydrocele in the age group older than 12 years was communicating and the history was suggestive of communication. Age was significantly associated with a patent processus vaginalis (OR 0.783, p Ͻ0.0001). Conclusions: It is possible in children older than 12 years to repair hydroceles through a scrotal incision unless the clinical history is suggestive of a communication. Children younger than 12 years should undergo inguinal exploration for hydrocele repair.
Giant unilateral abdominoscrotal hydrocele in an adult: Case report
International Urology and Nephrology, 2006
Abdominoscrotal hydrocele (ASH) is an apparently highly uncommon clinical entity especially in childhood. While hydrocele is among the commonest inguinal anomaly in adult, its extreme form ASH is infrequently reported form. ASH consists of two large sacs, both abdominal and scrotal, connecting with the inguinal canal. Surgical correction is mandatory. We present a 34-year-old man with giant ASH. He was treated with excision of hydrocele sac through an inguinal approach.