title: Large abdominoscrotal hydrocele: Uncommon surgical entity.
abstract: BACKGROUND
  An abdominoscrotal hydrocele (ASH) consists of a large inguinoscrotal hydrocele which communicates in an hour glass fashion with a large "intraabdominal component". Mostly affects single testis but very rarely can present bilaterally.
  
  
  METHODS
  We are presenting here a young 25 year old patient with large right sided scrotal swelling encroaching over lower abdomen. Clinically it was abdominoscrotal hydrocele which was confirmed with CT abdomen and later on subjected for surgery.
  
  
  CONCLUSIONS
  Abdominoscrotal hydrocele is rarest type of hydrocele; first described by Dupuytren. The etiology of ASH is unknown; however, different theories have been described in literature to explain the pathogenesis. Diagnosis of ASH is done by clinical examination and is confirmed by radiological examination. Though ultrasonography is the first choice, in few selected cases contrast enhanced computerized tomography or magnetic resonant imaging may be helpful for more anatomical delineation. It may present with various complications secondary to pressure exerted by the components of the ASH. Surgical excision of the sac is the only definitive treatment option. There is no role of conservative treatment. Sometimes, decompression of the cyst needed to ease the dissection of the sac.
  
  
  CONCLUSIONS
  Abdominoscrotal hydrocele differential should be considered while dealing with large lower abdominal swelling along with scrotal swelling.
authors.affiliation: Department of General Surgery, Seth G.S. Medical College & K.E.M. Hospital, Parel, Mumbai, India. Electronic address: drpramodk@yahoo.com.
authors.forename: Pramod M
authors.initials: PM
authors.lastname: Kamble
authors.affiliation: Department of General Surgery, Seth G.S. Medical College & K.E.M. Hospital, Parel, Mumbai, India. Electronic address: draparnadeshpande@yahoo.com.
authors.forename: Aparna A
authors.initials: AA
authors.lastname: Deshpande
authors.affiliation: Department of General Surgery, Seth G.S. Medical College & K.E.M. Hospital, Parel, Mumbai, India. Electronic address: drvinaythapar@sevenhillshospital.com.
authors.forename: Vinaykumar B
authors.initials: VB
authors.lastname: Thapar
authors.affiliation: Department of General Surgery, Seth G.S. Medical College & K.E.M. Hospital, Parel, Mumbai, India. Electronic address: drkrishanu_das@yahoo.co.in.
authors.forename: Krishanu
authors.initials: K
authors.lastname: Das
keywords: Abdominoscrotal; Hour glass; Hydrocele; Testis