Torsion of an Inguinal Hernia Sac in a Child: An Exceptionally Rare Cause of Acute Scrotum
2Faculty of Medical and Health Sciences, Tel Aviv University, Israel
Background:
Acute scrotum in children encompasses a spectrum of causes, ranging from benign self-limiting disorders conditions to life-threatening surgical emergencies. Among them, torsion of an inguinal hernia or hydrocele sac is an exceptionally rare entity that has been only sparcely described in the literature.
Case Presentation and Literature Review:
We report the case of an 8-year-old boy who presented with acute right inguinoscrotal pain and swelling. Surgical exploration revealed torsion and necrosis of an indirect inguinal hernia sac associated with a patent processus vaginalis and a chronic communicating hydrocele.
We describe the ultrasound, operative, and histopathologic findings highlighting the imaging features that may help distinguish this rare entity from more common causes of acute scrotum. In addition, we present a comprehensive review of the literature, identifying only 15 pediatric cases, none of which have previously been reported in the radiological literature.
Conclusion:
Although torsion of an inguinal hernia or hydrocele sac is exceedingly rare, it should be considered in the differential diagnosis of acute scrotum in children. Familiarity with its characteristic imaging findings may facilitate timely diagnosis, expedite appropriate surgical management, and ultimately improve patient outcomes.