TORSION OF AN INDIRECT HERNIA SAC - AN UNUSUAL CAUSE OF ACUTE SCROTALSWELLING IN CHILDREN

Objectives. An indirect inguinal hernia is a common cause of inguinosc rotal swelling in young boys. We describe 3 cases of an extremely unus ual entity that has a similar clinical presentation to more commonly d iagnosed intrascrotal processes. Methods, Two patients presented with acute hemiscrotal enlargement and pain, and a third patient presented with scrotal enlargement only. All patients underwent a scrotal ultras ound evaluation and subsequent inguinoscrotal exploration. Results. Al l patients had a multiseptated peritesticular fluid-filled mass on ult rasound evaluation. Subsequent inguinoscrotal exploration revealed a t orsion of the indirect hernia sac in each case. A high ligation and ex cision of the sac was curative. Conclusions. Torsion of a hernia sac i s an extremely rare entity, and current sonographic imaging fails to c learly diagnose this unusual phenomenon. Because pediatric urologists are commonly called to evaluate a child with an acutely swollen scrotu m, awareness of this diagnosis is important. (C) 1997, Elsevier Scienc e Inc. All rights reserved.