Letter to the editor

Hernia, Aug 2010

M. R. Joyce, J. D. Ryan, P. R. O’Connell

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Letter to the editor

Hernia M. R. Joyce J. D. Ryan P. R. O'Connell - We would like to congratulate Professor Olivier Armstrong for further delineating the relevant anatomy with respect to the canal of Nuck, in particular its clinical correlation. Hydrocele of the canal of Nuck is a rare entity. Even if the diagnosis is appreciated preoperatively, surgical exploration is recommended given the potential for co-existence of an inguinal or femoral hernia. Often one may identify only a cyst within the canal of Nuck structure but there is the potential to encounter clinically signiWcant structures and pathology, depending on the degree of obliteration of the process vaginalis of the inguinal canal during embryological development. Ovary, fallopian tube and uterus have been found within the canal of Nuck. Thus, care must be taken during dissection. An inguinal mass with cyclical pain related to menses raises the possibility of endometrial deposits within the canal of Nuck. Even if one suspects a peritoneal cyst within a femoral defect, we would, as per Professor Armstrong, recommend exploration and removal, which will then facilitate closure of the femoral opening preventing future potential for development of a femoral hernia. Professor Armstrong’s report adds to the literature and will help raise awareness for surgeons who encounter the above pathology.

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M. R. Joyce, J. D. Ryan, P. R. O’Connell. Letter to the editor, Hernia, 2010, 451-451, DOI: 10.1007/s10029-010-0679-7