Hydrocele of canal of nuck is a rare vulvar swelling. It appears as a swelling in labia majora involving labia . minora. It can be confused with Bartholin duct cyst.
Ms. M., a 22 years primigravida presented in the out patient department on 4th June, 2001 with complaint of amenorrhoea of 8 months duration and swelling in vulvar region for 20 days. On examination - She had normal built and was in good condition, Vital signs were normal, systemic examination revealed no abnormality. Abdominal examination reve aled - 32 weeks size uterus with vertex presentation, FHS - 146/min, regular. Local examination of vulvarevealed cystic, nontendar, Scm x 3 cm swelling in the upper 2/ 3rd of left labia majora and adjacent labiaminora.
Lower 1/3rd of vulva was normal. On aspiration - 10 ml of clear fluid was obtained, but swelling recurred again after a day. All her routine investigations were within normal limits. VDRL was negative.
Provisional diagnosis of hydrocele of the canal of nuck was made and the patient was operated on 7th June, 2001. A vertical incision was made on the medial sid e of left labia majora. The external inguinal ring was identified by inserting index finger along the round ligament upto the inguinal canal. The peritoneal sac was identified and excised. The peritoneum and external inguinal ring were closed with interrupted sutures. Labia majora was sutured. Histopathology of the of sac revealed - serous cyst with mononuclear cell infiltration suggestive of hronic inflammation.
