Giant Scrotal Hernia in a Tiny Male Infant

Andreas M. Fette*

Giant Scrotal Hernia in a Tiny Male Infant.

A Libyan mother presented her 1½ year old son with a giant swelling of his scrotum. The swelling of the left scrotum was constantly increasing since birth. Otherwise the boy was healthy and showed a regular development. However, because of this “giant mass” he was unable to walk freely. Both testicles, epidydymes and spermatic cords were easy palpable, painless, with no signs of inflammation. No enlarged lymph nodes were detectable in the groin. Regular male genitalia, no signs of a varicocele. Diaphanoscopic illumination of the scrotum for hydrocele testing was negative.

Acute painful scrotal swelling in children and infants is a common entity that requires prompt, accurate and appropriate therapy. The etiologies of these symptoms can range from benign self-limited conditions to more serious organ threatening problems like testicular torsion,3,4 or torsion respectively strangulation of the hernia sac. In these cases usually urgent surgical intervention is necessary.

Here, Eriki et al. presented a series of patients with an average age of 1.9 years (range 22 days – 10 years), with half of their patients presenting as soon as in the newborn period. In the majority of cases the hernias were right – sided. Several other authors presented cases of indirect hernia sac torsions,3,5,6,7,11 with their results being comparable to Eriki et al’ s findings. Khozeimeh et al. presented an extraordinary case of a newborn with giant bilateral inguinal hernias
complicated by in utero perforation and meconium peritonitis.

Authors from Brazil, finally, reported a case of a child with a ventriculo-peritoneal shunt, where the tip migrated into the scrotum mimicking a scrotal hernia.13 Indian authors, indeed, reported a case where a huge anterior urethral diverticulum was presenting as an inguino-scrotal swelling

Pediatr Neonatal Nurs Open J. 2014; 1(1): 12-15. doi: 10.17140/PNNOJ-1-103