Join Us | Latest Articles | Contact

Journal Home

Editorial Board

Recent Articles

Submit to this journal

Special Issues

Current issue

Clinical Medical Image Library

Pancreatitis Gone Nuts: Scrotal Hydrocele as a Complication of Severe Acute Pancreatitis

Ryan R Gaffney* and Matthew T Moyer

Division of Gastroenterology & Hepatology, Penn State Milton S. Hershey Medical Center, USA

*Corresponding author: Ryan R Gaffney, Division of Gastroenterology & Hepatology, Penn State Milton S. Hershey Medical Center and College of Medicine, HU33, 500 University Drive, Po Box 850, Hershey, PA 17033, USA, Tel: 717-531-1017, E-mail:
Clin Med Img Lib, CMIL-2-042, (Volume 2, Issue 5); ISSN: 2474-3682
Published Date: May 12, 2016
Citation: Gaffney RR, Moyer MT (2016) Pancreatitis Gone Nuts: Scrotal Hydrocele as a Complication of Severe Acute Pancreatitis. Clin Med Img Lib 2:042.
Copyright: © 2016 Gaffney RR, et al. This is an open-access content distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

A 33-year-old male with acute gallstone pancreatitis complicated by pancreatic fluid collection formation developed intense right-sided scrotal pain and swelling one week into his hospitalization. Computed tomography revealed inflammatory stranding near the pancreatic head with adjacent compression onto the stomach and duodenum (Left), and new, marked edema of the right inguinal canal and hemiscrotum with inflammatory peripancreatic fluid visibly tracking down into the pelvis (Center and Right) (Figure 1). Immediate scrotal exploration by the urology service yielded several hundred milliliters of cloudy, lipase-rich fluid from the right hydrocele sac, confirming the inguinoscrotal inflammatory fluid to be of pancreatic origin. The right testicle appeared viable and preserved without signs of infection or necrosis, and local percutaneous drainage was achieved intra-operatively via placement of two small caliber drains into the right scrotum to ensure complete resolution. The drains were removed seven days after insertion when output ceased. The patient eventually required endoscopic transluminal drainage of the evolving pancreatic head fluid collection for persistent anorexia and abdominal pain.

Clinically significant inguinoscrotal swelling from a pancreatic hydrocele is a rare complication of severe acute pancreatitis [1]. The mechanism is felt to occur by tracking of pancreatic fluid through weak fascial planes in the retroperitoneum along the psoas muscle and into the scrotum via the inguinal canal [2]. Once in the scrotum, inflammatory pancreatic ascites can readily accumulate and organize to form a pseudocyst - like collection that can cause infection and testicular necrosis [3]. Scrotal involvement in acute pancreatitis can also be confused with testicular torsion and other potential medical emergencies including epididymitis and incarcerated ventral/inguinal hernia, so it is generally recommended that patients be imaged quickly to determine if prompt surgical exploration is necessary [4]. Conservative management without surgery may be possible if there is no sign of testicular compromise [5].

International Journal of Anesthetics and Anesthesiology (ISSN: 2377-4630)
International Journal of Blood Research and Disorders   (ISSN: 2469-5696)
International Journal of Brain Disorders and Treatment (ISSN: 2469-5866)
International Journal of Cancer and Clinical Research (ISSN: 2378-3419)
International Journal of Clinical Cardiology (ISSN: 2469-5696)
Journal of Clinical Gastroenterology and Treatment (ISSN: 2469-584X)
Clinical Medical Reviews and Case Reports (ISSN: 2378-3656)
Journal of Dermatology Research and Therapy (ISSN: 2469-5750)
International Journal of Diabetes and Clinical Research (ISSN: 2377-3634)
Journal of Family Medicine and Disease Prevention (ISSN: 2469-5793)
Journal of Genetics and Genome Research (ISSN: 2378-3648)
Journal of Geriatric Medicine and Gerontology (ISSN: 2469-5858)
International Journal of Immunology and Immunotherapy (ISSN: 2378-3672)
International Journal of Medical Nano Research (ISSN: 2378-3664)
International Journal of Neurology and Neurotherapy (ISSN: 2378-3001)
International Archives of Nursing and Health Care (ISSN: 2469-5823)
International Journal of Ophthalmology and Clinical Research (ISSN: 2378-346X)
International Journal of Oral and Dental Health (ISSN: 2469-5734)
International Journal of Pathology and Clinical Research (ISSN: 2469-5807)
International Journal of Pediatric Research (ISSN: 2469-5769)
International Journal of Respiratory and Pulmonary Medicine (ISSN: 2378-3516)
Journal of Rheumatic Diseases and Treatment (ISSN: 2469-5726)
International Journal of Sports and Exercise Medicine (ISSN: 2469-5718)
International Journal of Stem Cell Research & Therapy (ISSN: 2469-570X)
International Journal of Surgery Research and Practice (ISSN: 2378-3397)
Trauma Cases and Reviews (ISSN: 2469-5777)
International Archives of Urology and Complications (ISSN: 2469-5742)
International Journal of Virology and AIDS (ISSN: 2469-567X)
More Journals

Contact Us

ClinMed International Library | Science Resource Online LLC
3511 Silverside Road, Suite 105, Wilmington, DE 19810, USA


Get Email alerts
Creative Commons License
Open Access
by ClinMed International Library is licensed under a Creative Commons Attribution 4.0 International License based on a work at
Copyright © 2017 ClinMed International Library. All Rights Reserved.