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Year : 2021  |  Volume : 1  |  Issue : 1  |  Page : 43

Giant abdominoscrotal hydrocele in decompensated liver disease


Department of Hepatology and Transplant Hepatology, Gleneagles Global Health City, Chennai, Tamil Nadu, India

Date of Submission06-Aug-2020
Date of Decision06-Aug-2020
Date of Acceptance06-Aug-2020
Date of Web Publication04-Dec-2020

Correspondence Address:
Jacob Nikhil Thomas
Department of Hepatology and Transplant Hepatology, Gleneagles Global Health City, Chennai - 600 100, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ghep.ghep_8_20

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How to cite this article:
Thomas JN, Varghese J. Giant abdominoscrotal hydrocele in decompensated liver disease. Gastroenterol Hepatol Endosc Pract 2021;1:43

How to cite this URL:
Thomas JN, Varghese J. Giant abdominoscrotal hydrocele in decompensated liver disease. Gastroenterol Hepatol Endosc Pract [serial online] 2021 [cited 2021 Apr 22];1:43. Available from: http://www.ghepjournal.com/text.asp?2021/1/1/43/302222




  Case Detail Top


Giant abdominoscrotal hydrocele (ASH) is a rare clinical entity described by Parcival-Pott in 1777 and was given the name l’Hydrocele en bissac” by Dupuytren. It was later changed to ASH, a globally accepted term.[1] A congenital intercommunication between the abdominal and scrotal sacs is the cardinal feature. In cirrhosis, a preexisting small hydrocele may enlarge due to a communication between the peritoneal cavity and scrotum via the patent processus vaginalis. Increased intra-abdominal pressure from massive ascites may augment the flow of ascitic fluid into the scrotum.[2] We present a case of massive right-sided ASH in a 72 year old male with ethanol-related decompensated chronic liver disease, who came to our center with the complaints of abdominal distension and right scrotal swelling extending up to his right knee joint. Physical examination revealed massive ascites and right-sided giant hydrocele. Computed tomography scan [Figure 1] showed a communicating ASH, with ascites tracking into the right hemi-scrotum through the inguinal canal. A small ASH was also noted in the left side. He was registered for deceased donor liver transplantation. Adequate diuretic therapy was given with large-volume paracentesis. Single-time percutaneous drainage of the hydrocele was done for symptomatic relief of severe scrotal swelling and associated pain.
Figure 1: Computed tomography scan showing a giant right-sided abdominoscrotal hydrocele (yellow arrow) with ascites in the intra-abdominal cavity (blue arrow). Communication between the peritoneal cavity and scrotum is illustrated by the red arrow

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Gadelkareem RA. Abdominoscrotal hydrocele: A systematic review and proposed clinical grading. Afr J Urol 2018;24:83-92.  Back to cited text no. 1
    
2.
Ergenc H, Eminler AT, Ilce HT, Koksal AS, Parlak E. Giant hydrocele in a decompensated cirrhotic patient: Not always up sometimes down. Austin J Nucl Med Radiother 2016;3:1018.  Back to cited text no. 2
    


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