4 days of right lower abdominal pain and nausea. Previous surgical correction of hypospadias and right inguinal hernia repair. On examination, palpable non-reducible right inguinal swelling and tenderness. Normal testicular examination. CT to look for recurrent acute inguinal hernia.
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The right inguinal canal is swollen when compared to the left. There is inflammatory fat stranding within the canal, extending to the scrotum. The intrapelvic vas deferens on the right is hyper-enhancing when compared to the left. The seminal vesicles appear normal. There is no inguinal hernia.
The finding of inflammation centered on the right spermatic cord within the inguinal canal with mild hyperenhancement of the vas deferens, and the absence of a recurrent inguinal hernia, led to a radiologic diagnosis of vasitis. A course of oral ciprofloxacin was commenced and he was discharged.
Case published with assistance from Dr Vikas Shah.