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[Meconium periorchitis. Two case reports]
Case Reports:
Two cases of meconium periorchitis respectively in a ten-day- and a five-month-old infant are reported. The presenting symptom was a scrotal mass, isolated in one case and associated with pain and inflammation in the other case. Intraoperative histological diagnosis allowed conservative surgery in one case.
Comments:
About 40 cases of scrotal manifestations of an intrauterine perforation of the gastrointestinal tract are reported in the literature. In cases with associated intraperitoneal calcifications, the diagnosis is easy and surgical exploration may be avoided, spontaneous resolution being the rule. However, in half of the cases, a scrotal mass is the only manifestation and raises the question of a testicular tumor.
Conclusion:
Unfamiliarity with this unusual entity may lead to unnecessary orchiectomy.
Insights
Meconium periorchitis, a rare condition caused by intrauterine gastrointestinal perforation, can present as a scrotal mass in infants. Early diagnosis is crucial to avoid unnecessary orchiectomy.
Area of Science:
- Pediatric Surgery
- Neonatology
- Gastroenterology
Background:
- Meconium periorchitis is a rare complication of intrauterine gastrointestinal perforation.
- It can manifest in neonates and infants, presenting diagnostic challenges.
Observation:
- Two cases of meconium periorchitis in infants presented with scrotal masses.
- Symptoms included isolated masses or masses with pain and inflammation.
- Intraoperative histology aided conservative surgical decisions in one case.
Findings:
- Scrotal masses are the sole manifestation in approximately half of meconium periorchitis cases.
- This presentation can mimic testicular tumors, complicating diagnosis.
- Intraperitoneal calcifications, when present, facilitate diagnosis and may allow for non-surgical management.
Implications:
- Unfamiliarity with meconium periorchitis can lead to misdiagnosis and unnecessary orchiectomy.
- Awareness of this condition is vital for appropriate clinical management in infants with scrotal masses.
- Accurate diagnosis can prevent surgical overtreatment and ensure conservative management when indicated.