PMC5554997_01
Ultrasound examination. Sagittal image of the left scrotal mass demonstrating the difficulty to appreciate the full extent of the abnormality.
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However, extension of the left scrotal mass with the abdomen was not easily identified on ultrasound examination, as illustrated in Figure 1.
Diagnostic laparoscopy. Bulging cystic mass demonstrating a right abdominoscrotal hydrocele.
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Diagnostic laparoscopy revealed a massive right-sided cystic structure extending from the internal inguinal ring displacing the colon and extending up to the level of the umbilicus, consistent with ASH (Figure 2).
(a) Diagnostic laparoscopy. Left internal inguinal ring without palpation of the ipsilateral hemiscrotum. (b) Diagnostic laparoscopy. Left internal inguinal ring with palpation of the ipsilateral hemiscrotum.
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The left internal ring was closed and did not reveal an abdominal cystic mass (Figure 3(a)); however, with palpation of the scrotum on the left side, the hydrocele sac was seen to enlarge into the abdominal cavity (Figure 3(b)).