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E2034. The Inguinal Canal: A Busy Route with Numerous Travelers
Authors
  1. Anas Saeed Bamashmos; Yale New Haven Health Bridgeport Hospital
  2. Ayah Megahed; Yale New Haven Health Bridgeport Hospital
  3. Kareem Elfatairy; Yale New Haven Health Bridgeport Hospital
  4. Ashkan Heshmatzade-Behzadi; Yale New Haven Health Bridgeport Hospital
  5. Gaurav Parmar; Yale New Haven Health Bridgeport Hospital
  6. Noel Velasco; Yale New Haven Health Bridgeport Hospital
Background
The inguinal canal is a physiological route between the anterior abdominal wall in the region of the groin. It transmits the spermatic cord in males and the round ligaments in females, and the ilioinguinal nerve in both sexes. All these structures have a garden variety of pathologies that can be confusing in some scenarios. Occasionally, inguinal canal lesions are difficult to diagnose in one radiological modality and require a comprehensive approach starting from careful history taking and physical exams followed by appropriate imaging studies (1). In this review presentation, we present the most common inguinal canal lesions and their radiological features. We briefly describe the most common congenital anomalies and their complications. Next, we describe the malignant lesions that can involve the inguinal canal such as primary liposarcoma, Burkitt lymphoma, testicular carcinoma, and secondary tumors.

Educational Goals / Teaching Points
• Identify the anatomy and contents of the inguinal canal and the most common congenital anomalies and their complications. • Discuss the imaging findings of the common benign conditions of inguinal canal contents such as inguinal hernia, lipomas, abscesses, hematoma, and varicocele. • Present the most frequent primary and secondary malignant lesions of the inguinal canal and radiological features of each of them.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Introduction. Anatomy of the inguinal canal. o Embryology o Pediatrics o Adults Congenital anomalies of the inguinal canal. Benign inguinal canal lesions. o Spermatic cord lipoma o Hematoma & false aneurysm o Abscess o Neurofibroma o Varicocele o Desmoid tumor o Air and contrast material o Hydrocele o Penile prostheses o Rare processes: Pancreatic pseudocyst, synovial cyst of the hip, endometriosis of the canal of Nuck. Malignant inguinal canal lesions. o Liposarcoma o Burkitt lymphoma o Testicular carcinoma o Sarcoma o Angiomyofibroblastoma-like tumor Summary.

Conclusion
The inguinal canal contains multiple structures and various pathologies. In this presentation, we discuss the imaging features of these lesions and use a comprehensive approach for reaching the right diagnosis.