World J Mens Health.  2012 Aug;30(2):150-152.

Torsion of an Indirect Hernia Sac Causing Acute Scrotal Swelling in a Child

• Nam JK
• Ahn JH
• Kim HW
• Park HJ
• Lee SD
• Chung MK

Abstract

Torsion of a hernia sac is an extremely rare condition that presents as acute scrotum in children. We report a case of a 6-year-old boy who presented with an acute scrotum and was found during surgical exploration to have torsion of an indirect hernia sac associated with hydrocele. Upon scrotal exploration, deterioration of the scrotum due to inflammatory changes was found. A necrotic cyst was recognized within a communicating hydrocele of the scrotum and was twisted at an angle of about 360degrees. All urologists should be aware of this special condition in the differential diagnosis of acute scrotum.

Keyword

Scrotum; Hernia, inguinal; Torsion abnormality

MeSH Terms

Child
Diagnosis, Differential
Hernia
Hernia, Inguinal
Humans
Scrotum
Torsion Abnormality

Figure

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  Fig. 1 Ultrasonography revealed a normal right testis with septated paratesticular cystic mass.

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  Fig. 2 The hernia sac filled with hemorrhagic fluid (white arrow) was separated from right testis. A hernia sac communicated directly with the peritoneum (black arrow) and was twisted an angle of about 360° and contained no internal contents.

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