外科ジャーナル

Inguinoscrotal Swelling an Unusual Presentation of the Intra-abdominal Pathologies

Abstract

Amaresh Aruni, K Hemanth Kumar, Harjeet Singh and Anish Chowdhury 

Inguinal hernia and lymphadenopathy are the most common causes of the inguinal swelling which can be diagnosed clinically, but the intraabdominal pathologies presenting primarily as an inguinal swelling and masquerading as inguinal hernia are often rare. We report 3 cases of the different primary intraabdominal pathologies presenting atypically as inguinal swelling and causing a diagnostic dilemma. Thorough clinical history, examination and better imaging accurate preoperative diagnosis and plan of management. 1^st case was gallstone related necrotizing pancreatitis presenting with left lumbar pain and left inguinal swelling due to collection tracked into inguinal canal through patent processus vaginalis, managed conservatively with percutaneous drain for collection. 2^nd case was metastatic liposarcoma in the left inguinal region who initially underwent excision of retroperitoneal sarcoma and received adjuvant chemoradiotherapy, he underwent wide local excision. 3^rd case was low grade appendiceal mucinous neoplasm presenting initially as right indirect inguinal hernia followed by left inguinal hernia due to the mucinous material tracking into inguinal canal through processus vaginalis. Managed by herniorrhaphy and right hemicolectomy.