Neglected torsion of hernia sac within hydrocele: a case report

Most of the cases of torsion hernia sac in the literature were presented as acute scrotum. In this case the presentation was painless swelling, which is considered to be the 3rd case in the English literature as far as we know. A 4-year-old boy presented with painless swelling in his right hemiscrotum. The surgical exploration revealed a sac twisted inside another sac. A theory proposed that a slim, membranous hernia sac could potentially get folded into a hydrocele and later twist. This diagnosis should be suspected as a rare differential diagnosis of scrotal swelling in the pediatric age group.