Inguinoscrotal swellings in childhood: a clinico-diagnostic approach to differential diagnosis

Dawood Iqbal Wani, Ankit Prabhakar, Shivani Sharma, Rezwana Nafees


Background: Inguinoscrotal diseases are one of the commonest group of disorders seen in clinical surgical practice. A wide range of swellings are seen in this region in children and includes hydrocele, torsion testis, ectopic testis, lymphadenopathy, inguinal hernias, cysts, epididymitis, orchitis, tumors etc. Vigilant clinical and radiological evaluation of inguinoscrotum for varying diseases helps in proper diagnosis and surgical management of its differential diagnosis.

Methods: The present study was conducted as an observational study over a period of 10 months and enrolled a total of 50 patients.

Results: In this study, 31 cases had hydrocele, 14 cases had inguinal hernia, 2 cases had epididymorchitis, 2 cases had lymphadenopathy and one case had idiopathic scrotal edema. Individual diseases had varying presentations, clinical findings and post-operative findings.

Conclusions: There is a varying broad spectrum of swellings in the inguinoscrotal region in young male children. It was concluded that proper clinical and radiological evaluation of the patient helps to timely diagnose the disease and hence help in identifying correct approach to the management of the case.


Child, Hernia, Hydrocele, Inguinoscrotum, Swelling

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Rubenstein RA, Dogra VS, Seftel AD. Benign intrascrotal lesions. J Urol. 2004;171(5):1765-72.

Lloyd David A. Inguinal and femoral hernia, Operative paediatric surgery, 1st ed. McGraw-Hill; 2003:543-554.

Rowe M, Lloyd DA. Inguinal hernia, Paediatric surgery, 4th edition, yearbook medical publishers inc, Chicago, volume 2; 1986:779-791.

Rowe M, Marchildon M. Inguinal hernia and hydroceles in infants and children. Surg Clin North Am. 1981;61:1137-45.

Kaplan GW, King LR. Acute scrotal swelling in children. J Urol. 1970;104(1):219-23.

Celestino A, Enriquez G, Fite M. Gray-scale and colour Doppler sonography of scrotal disorders in children: an update. Radiographics. 2005;25:1197-214.

Tam P. Inguinal hernia. Neonatal Surgery, 3rd ed. Butterworth, London; 1990:367-375.

Grosfeld J, Cooney D. Inguinal hernia after ventriculo-peritoneal shunt for hydrocephalus. J Paediat Surg. 1974,9:311.

Harper R, Gracia A, Sia C. Inguinal hernia- a common problem of premature infants weighing 1000 gm or less at birth. Paediatr. 1975;56:112.

Skoog SJ, Conlin MJ. Paediatric hernias and hydroceles - the urologist’s perspective. Urol Clin North Am. 1995;22(1):119-30.

Mark D. Inguinal hernia, hydrocele and the undescended testis. Br Med J. 1996;312:564-7.

Kapur P, Caty MG, Glick PL. Paediatric hernias and hydroceles. Paediatr Clin North Am. 1998;45(4):773-88.

Frosberg R, Mahin H. Femoral hernia in children. Am J Surg. 1965;109:470.

Immordino P. Femoral hernia in infancy and childhood. J Paediatr Surg. 1972;7:1-43.

Cromie WJ. Congenital anomalies of the testis, vas, epididymis, and inguinal canal. Urol Clin North Ame. 1978;5(1):237-52.

Gilchrist BF, Lobe TE. The acute groin in paediatrics. Clin Paediatr. 1992;488-496.

Wilson D-Storey. Scrotal swellings in the under 5s. Arch Dis Childhood. 1987;62:50-2.

Abatanga FA, Amaning EP. Paediatric elective surgical conditions as seen at a referral hospital in Kumasi, Ghana. ANZ J Surg. 2002;72:890-2.

Bullantyne AG, Jawaheer G, Munro FD. Contralateral groin exploration is not justified in infants with a unilateral inguinal hernia. Br J Surg. 2001;88:720-3.

Carneiro PMR. Inguinal herniotomy in children. East Af Med J. 1990;67(5):359-64.

Venugopal S. Inguinal hernia in children. West Indian Med J. 1993;42(1):24-6.