A Case Giving Proof of Pathogenesis of Abdominoscrotal Hydrocele: A Case Report

An abdominoscrotal hydrocele (ASH) is an uncommon condition characterized by cystic mass that occupies the scrotum and abdomen. The characteristic aspect is the presence of two hydrocele sacs in the abdominal cavity and the scrotum, and compression of one side causes enlargement of the other side, thereby connecting the two sacs. There are several hypotheses regarding the occurrence of ASH. However, the evidence of the hypotheses is lacking. The patient was a 52-year-old male. During observation of the right inguinoscrotal hydrocele, the patient complained of a palpable mass lesion on the right lower quadrant of the abdomen. Physical examination revealed ASH that occurred with the growth of the inguinoscrotal hydrocele. This was further confirmed by sequential imaging test thereby proposing the verification of cephalad extension of hydrocele. The surgical excision was recommended and inguinal exploration was performed under general anesthesia. No evidence of relapse was observed during the 2-year follow-up period after surgery. The present case proves the cephalad extension of hydrocele among other hypotheses on the etiology of ASH.

Abdominoscrotal Hydrocele: An Uncommon Cause of Abdominoscrotal Cystic Swelling

Abdominoscrotal hydrocele (ASH) consists of fluid-filled intercommunicating inguinoscrotal and abdominal sac with a characteristic hourglass-like picture on CECT, which usually affects single testis and a rare cause of abdominoscrotal cystic swelling. The precise etiology of ASH is not known. Ultrasonography is the initial diagnostic modality of choice as it demonstrates the intercommunication between the two sacs and also identifies any abnormality of the testis and genitourinary tract. We are reporting a case of a 27-year-old patient presented in the General Surgery OPD of Acharya Vinoba Bhave Hospital in 2019 with bilateral scrotal and abdominal swelling. On examination, cross fluctuation was positive between left hydrocele and abdominal swelling, raising suspicion of ASH, which was confirmed on CECT. The patient underwent excision of sac through left inguinoscrotal approach and an uneventful postoperative course.

Abdominoscrotal Hematocele in an Adult and Its Successful Treatment

Abdominoscrotal hydrocele (ASH) is a variant of hydrocele rare to occur in adults. ASH has two sacs, one in the scrotum and one in the abdomen connected through the inguinal canal. Abdominoscrotal hematocele is a rare complication of ASH. We present a 57-year-old male patient, presented to us in August 2019 to JIPMER, Puducherry, India, with complaints of swelling in the scrotum for 15years and abdominal pain for two months. Both the swellings were soft, and cross fluctuation was present. Imaging confirmed the diagnosis of ASH. We did diagnostic laparoscopy, and the abdominal sac was decompressed and found to have thick brownish fluid suggestive of hematocele. We could demonstrate that both sacs were connected. Due to difficulty in the dissection of the sac, the procedure was converted to an open procedure. Both the sacs were excised, and Lytle’s repair was done for the dilated internal ring. Keywords: Testicular Hydrocele, Scrotal Hydrocele, Hydrocele, Hematocele, Testicular Hematocele, Scrotal Hematoceles, Laparoscopic Surgical Procedure, Laparoscopic Surgery