Acute Scrotal Pain-Inflammatory Noncommunicating Hydrocele

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Acute scrotal pain
(a) Both testes were normal sized with normal blood flow. (b) The hydrocele wall was as thick as 3–5 mm (scale bar = 1 cm). (c) The omentum is inserted into the right inguinal canal. The blood flow was detected.

Hydrocele inflammation causing scrotal pain and redness.

This article describes the case of a 14-month old boy diagnosed with an acute scrotal pain caused by a noncommunicating hydrocele. The patient presented with a hydrocele in the right spermatic cord with a swollen scrotum. His symptoms included a 4-day history of intermittent right scrotum pain, a red and swollen scrotum. In addition, the patient was in a grumpy mood, however, cremasteric reflux was absent.

Doctors advised a urine test which showed no white blood cells and a slight increase in CRP. An ultrasound was performed which showed normal testes and epididymis. And colour Doppler US showed normal blood flow. The cranial of the right testis further showed a low-echoic hydrocele with multispetum. The wall of the hydrocele was as thick as 3 to 5 mm. The Doppler US also showed an omentum present in the patient’s processus vaginalis in the right inguinal canal. However, the partial omental incarcerating could not be ruled out completely because of the sensitivity of the US. Inguinal exploration further showed a processus vaginalis (PV) with the inserted omentum. However, there was no evidence of necrotic or adherent tissue.

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The scrotum was red and swollen.

There was no communication between the PV and hydrocele. The omentum itself was not causing the pain, as concluded with the surgical findings. The testis examination showed a normal coloured testis with no torsion of the spermatic cord. Although, the hydrocele was seen to be adhering to the surrounding tissue. Similarly, was much thicker and more solid compared to the pediatric testicular hydrocele. Histopathology showed oedema in the wall with fibrin precipitation and lymphocyte infiltration. This indicated that the severe inflammation was the cause of scrotal pain and redness.

References

Unusual Cause of Acute Scrotal Pain-Inflammatory Noncommunicating Hydrocele: A Pediatric Case Report https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5822865/

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Dr. Aiman Shahab is a dentist with a bachelor’s degree from Dow University of Health Sciences. She is an experienced freelance writer with a demonstrated history of working in the health industry. Skilled in general dentistry, she is currently working as an associate dentist at a private dental clinic in Karachi, freelance content writer and as a part time science instructor with Little Medical School. She has also been an ambassador for PDC in the past from the year 2016 – 2018, and her responsibilities included acting as a representative and volunteer for PDC with an intention to make the dental community of Pakistan more connected and to work for benefiting the underprivileged. When she’s not working, you’ll either find her reading or aimlessly walking around for the sake of exploring. Her future plans include getting a master’s degree in maxillofacial and oral surgery, settled in a metropolitan city of North America.

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