Complicated inguinal hernia repair - scrotal abscess

Case contributed by Dr Michael P Hartung

Presentation

Hernia repair 2 weeks prior, with left scrotal enlargement. Recent removal of non-draining scrotal drain.

Patient Data

Gender: Male

Very large bilobed enhancing collections in the left inguinal canal and scrotum. The larger (anterior) collection contains air and appears likely to communicate with a fistulous tract extending to the skin surface, representing the prior drainage catheter tract which was recently removed.

Extensive scrotal enlargement and edema.

CT

After percutaneous drainage

A pigtail catheter has been placed in the larger, anterior collection, which has decreased in size. The posterior collection is unchanged in size and appearance. Persistent extensive scrotal edema.

Case Discussion

Unusual case showing a complication of inguinal hernia repair, with large bilobed postoperative collection/abscesses within the scrotum. Surprisingly, no bacterial growth was present in the culture from the larger drained collection. The anterior collection eventually resolved and was replaced by a recurrent bowel containing hernia. The smaller (posterior) collection remained undrained.

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Case information

rID: 61804
Published: 20th Jul 2018
Last edited: 14th Aug 2019
System: Urogenital
Inclusion in quiz mode: Included

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