Simultaneous indirect inguinal hernia finding in an infant with abdominoscrotal hydrocele

INTRODUCTION: Abdominoscrotal hydrocele is a rare condition of vaginal hydrocele. Ipsilateral cryptorchidism is frequently reported as an associated congenital anomaly, however, ipsilateral indirect inguinal hernia has never been reported as an accompanying anomaly. CASE PRESENTATION: We reported a case of 6-month-old boy with a huge cystic mass at left scrotum extending upward to lower abdomen passing through inguinal canal. There was an unusual presentation in that this bulging mass could be entirely reduced into abdomen, mimicking patients who presented with reducible inguinal hernia. Intraoperatively, the patient was found that not only abdominoscrotal hydrocele and undescended testes were presented, but also hernia sac was simultaneously encountered. He was successfully treated and recovered uneventfully. DISCUSSION: According to the natural history of abdominoscrotal hydrocele resembling that of non-communicating hydrocele, it could be treated conservatively without surgery. However, several conditions caused by pressure effect will not be relieved and testicular dysmorphism will also not be corrected. In addition, as presented in this report, should there also be an inguinal hernia, the hernia sac should be left in place without any surgical correction. As a result, we recommend that all patients with abdominoscrotal hydrocele should be surgically treated if there is no contraindication. CONCLUSION: The presence of hernia sac might produce a unique presentation. Since we do not know whether the patients who have abdominoscrotal hydrocele will be accompanied by indirect inguinal hernia, the patients should be treated with surgery unless they were in condition in which surgery cannot be performed.