D. Weber (Uniklinik Leipzig)  

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3 Weeks  

Male  

Pelvis-Testis  

circulatory  

3 week old male infant, painful swelling in the groin area for a few hours.  

N/A  

<- view Ultrasound 1

Ultrasound 1: Right-sided presentation of a 9 mm wide inguinal canal and within it a well differentiated and vascularized bowel loop without peristalsis. Slightly hyperechoic testis, testicular hydrocele.




<- view Ultrasound 2

Ultrasound 2: The right testicle is increased in echogenicity and is slightly larger (in comparison to the left testicle), although the echostructure is homogenic and has a smooth margin.




<- view Ultrasound 3

Ultrasound 3: No evidence of perfusion in the slightly enlargend and hyperechogenic right testicle (with a good presentation of the color dopper signal in the left testicle / with identical parameters). Testicular hydrocele on the right.




<- view Ultrasound 4

Ultrasound 4: 1/2 hour after manually reposition of the bowel loop. Similar echogenicity and size of both testicles. In the color doppler mode, there was somewhat increased perfusion of the testicular parenchyma on the right side (clearly reactive). Right testicular hydrocele is decreasing in size.

 

Total constellation (Consens)  

Testicular torsion, incarcerated hernia  

Uncomplicated nonoperative reposition of the inguinal hernia, subsequent improvement of perfusion and regression of the hydrocele.  

After sonographic diagnosis followed the nonoperative reposition. Interestingly, a diminished testicular perfusion may also happen in a not incarcerated inguinal hernia. After reposition of the hernia followed a normalisation of the previously diminshed perfusion of the testis.  

N/A  

1. Medline:
Hernandez-Richter T, Meyer G, Schardey HM, Rau HG, Schildberg FW.
Transabdominal preperitoneal hernia repair (TAPP).
Results of 1,000 completed operations
Zentralbl Chir. 1999;124(7):657-63.[Article in German]

2. Medline:
Kupczyk-Joeris D, Kalb A, Hofer M, Toens C, Schumpelick V.
Doppler sonography of testicular circulation following reconstruction of inguinal hernia
Chirurg. 1989 Aug;60(8):536-40.  

Inguinal hernia, non incarcerated, Incarceration, hernia incarceration, decreased testicular perfusion, not incarcerated ingunial hernia, testicular torsion, testes, groin, hernia, testicular perfusion, hyperechogenicity, child, childhood, pediatric radiology  

D Weber. Inguinal hernia (non incarcerated) with testicular hypoperfusion. PedRad [serial online] vol 4, no. 1.
URL: www.PedRad.info/?search=20040106222620