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Communicating hematocele in children following splenic rupture: diagnosis and management
1Department of Urology, Ochsner Clinic and Alton Ochsner Medical Foundation and the Louisiana State University School of Medicine, New Orleans, Louisiana 70121, USA.
Insights
Acute hematocele in boys can result from blunt abdominal trauma, not just direct injury. Early treatment of the abdominal injury is crucial before surgical repair of the communicating hydrocele.
Area of Science:
- Pediatric Surgery
- Trauma Surgery
- Urology
Background:
- Acute hematocele typically results from direct testicular trauma.
- Blood in the tunica vaginalis can occur with blunt abdominal injury if a communicating hydrocele is present.
Observation:
- Two cases of boys presenting with scrotal swelling due to communicating hematoceles were observed.
- Both cases involved a patent processus vaginalis and splenic laceration.
Findings:
- The communicating hematoceles were secondary to splenic laceration from blunt abdominal trauma.
- Early recognition and management of the abdominal source of bleeding is essential.
Implications:
- This highlights a less common cause of hematocele in pediatric patients.
- Management should prioritize treating the intra-abdominal injury followed by elective repair of the hydrocele/hematocele.
Abstract:
Acute hematocele is commonly associated with direct testicular trauma. Blood within the tunica vaginalis may infrequently accompany blunt abdominal injury in the presence of a communicating hydrocele. Optimal management involves early recognition and treatment of the abdominal source of bleeding. Elective repair of the communicating hydrocele/hematocele should follow. We report 2 cases of boys with scrotal swelling due to communicating hematoceles. Both cases were associated with a patent processus vaginalis and splenic laceration secondary to blunt trauma.