Krause Hardy, Hass Hans-Juergen, von Rohden Ludwig, Kroker Steffen, Buhtz Peter, Jaekel Anja, Meyer Frank
University Hospital, Magdeburg (Germany), Division of Pediatric Surgery, Department of Surgery, Leipziger Strasse 44, Magdeburg, 39120, Germany.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.04.2009.1801. Epub 2009 Sep 1.
A testicular tumour-like lesion or a solid extratesticular mass are serious postnatal problems with a broad spectrum of inflammatory or tumorous causes and possible differential diagnoses. In this case report, an extraordinary case of a newborn boy with a rare cause of a periorchitis is described.A premature boy infant (25-year-old mother with obesity) was diagnosed as having a disturbance of prosperity. A plain film of the abdomen showed a dilated intestine (no pathological findings in abdominal ultrasound, in particular, no ascites). After 3 postnatal months of clinical observation at the hospital including temporary parenteral nutrition, hydrocele at both sides was diagnosed. Therefore, the boy underwent surgical exploration. Intraoperatively, the processus vaginalis peritonei was surprisingly filled with meconium; because of that, the situs was extensively rinsed. In addition, the boy underwent an operation for the right and left hydrocele. The testes were preserved (on follow-up investigation there were no further problems).Pathohistological investigation confirmed meconium periorchitis, which is a rare postnatal disease and which can only develop in cases of former meconium peritonitis and if the processus vaginalis peritonei is open. The precise details of cause and pathophysiology in this case may significantly help in avoiding unnecessary orchiectomy.
睾丸肿瘤样病变或睾丸外实性肿块是严重的产后问题，其病因广泛，包括炎症性或肿瘤性，且有多种可能的鉴别诊断。在本病例报告中，描述了一名患有罕见的睾丸周炎病因的男婴的特殊病例。一名早产男婴（母亲25岁，肥胖）被诊断为发育障碍。腹部平片显示肠道扩张（腹部超声无病理发现，尤其是无腹水）。在医院进行了3个月的临床观察，包括临时肠外营养后，诊断出双侧鞘膜积液。因此，该男婴接受了手术探查。术中，腹膜鞘突意外充满胎粪；因此，对手术部位进行了广泛冲洗。此外，该男婴还接受了双侧鞘膜积液手术。睾丸得以保留（随访调查未发现进一步问题）。病理组织学检查证实为胎粪性睾丸周炎，这是一种罕见的产后疾病，仅在既往有胎粪性腹膜炎且腹膜鞘突开放的情况下才会发生。本病例病因和病理生理学的确切细节可能对避免不必要的睾丸切除术有很大帮助。
