[Detection of open processus vaginalis by radionuclide scintigraphy]

The processus vaginalis usually obliterates spontaneously from the inguinal ring to the scrotum after the descent of testis has been completed. Under certain conditions, it can be reopened. In present reports, 3 cases with open processus vaginalis were described. The first one is a case of uremia due to chronic glomerulonephritis, suddenly suffering from right scrotal and penile swelling, following continuous ambulatory peritoneal dialysis (CAPD) for 4 months. The second one is a case of uremia, due to unknown etiology, suddenly developing right scrotal and penile swelling after 5 months of CAPD. The third one is a case with uremia of uncertain etiology, suffering from bilateral scrotal and penile swelling in the first month of CAPD, following a wrong procedure, by adding some 200cc more dialysate. Three mCi of Tc-99m phytate or pertechnetate, added into the bag of peritoneal dialysate for each patient, allowed us to visualize a peritoneo-vaginal communication. After surgery one of the patients who had been given followup treatment by radionuclide scintigraphy showed no passage of the labeled infusion in the swollen side of the scrotum. A previous postmortem study of adults dying without clinically apparent inguinal hernia demonstrated an open processus vaginalis in 20% of groins examined. Thus, this study suggests that in placement of catheters for CAPD or ventriculo-peritoneal shunt, Tc-99m pertechnetate/phytate may be given through intraperitoneal injection to detect a subclinical open processus vaginalis.