Tasneem S Uzair, Zaki Uddin Oonwala, Mustansir Vellani.
A rare case of Cystic Hygroma presenting as Inguinal Hernia.
J Coll Physicians Surg Pak Jan ;9(3):149-50.

Cystic hygroma (lymphangioma) is a rare congenital condition arising from abnormal cysitc dilatation of lymph channels. The commonest site is neck but rare cases have been reported in unusual sites. It is important to identify this condition to offer adequate excision and prevent recurrence. This is a case report of 5 years age male child who presented as a typical case of inguinal hernia, but on exploration it was found to be a large retroperitoneal lymphangioma extending from lower pole of left kidney to scrotum. Complete excision was done by extending the incision for a laparotomy. There was no recurrence after two years of followup. This is a unique presentation of cystic hygroma not found to be reported in literature before. Recognition of this condition led to its complete excision.

CASE REPORT: A five years old male child was admitted in our surgical unit on January 1990 with history of swelling in left scrotum since birth. The swelling was reducible on lying down and became more prominent on crying. There were no urinary complaints or any other associated symptoms. There was no history of any congenital or familial disease in the family. On examination the child was healthy and active with normal respiratory, cardiovascular, and nervous system. On abdominal examination, there was no mass or viscera palpable. Local examination showed a left inguinoscrotal swelling which was reducible, soft in consistency, non-tender, with a positive cough impulse and transillumination. Upper limit of the swelling was not reachable. Both testes and external genitalia were normal. Routine blood and urine tests were normal. A preoperative diagnosis of inguinal hernia was made.

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