Prenatal diagnosis of an inguinoscrotal hernia: sonographic and magnetic resonance imaging findings

Antenatal diagnosis and management of fetal inguinoscrotal hernia: A case report with literature review

Primary inguinal hernia is a common pediatric surgical condition with an incidence of 1%-4%, which is higher in male or premature newborns. It is characterized by the protrusion of abdominal contents through inguinal canal in newborns. However, prenatal fetal inguinal hernia is a rare condition because the pressure of amniotic fluid is similar to intra-abdominal pressure. Only 19 English publications were found with 21 reported cases until now. We report belatedly discovered inguinoscrotal hernia at 38+0 weeks' gestation. Usually, the fetal testicular descent begins from 24 to 25 weeks' gestation, and it is found after 32 weeks of gestational age in 97% of the fetuses. Therefore, it is necessary to get into the habit of checking fetal testicles during routine US after at least 32 weeks of gestational age.

Inguinoscrotal Hernia, a Possible Cause of Rapidly Developing Fetal Scrotal Mass: Case Report and Literature Update

Inguinoscrotal hernia is a common pediatric disease but a rare condition in the fetus. We present a case, from our institution, of fetal inguinoscrotal hernia with possible rapid development. In addition to our case, we present a literature update on fetal inguinoscrotal hernia in order to enhance the ability to recognize it from the other scrotal masses on ultrasound. Antenatal management, differential diagnosis and postnatal management are also discussed.

Two cases of fetal inguinoscrotal hernia and review of the literature

Fetal inguinal hernia is quite rare and here we report two cases of prenatally diagnosed inguinoscrotal hernia to add to the limited understanding of this rare condition. The disappearance of blood flow signal in the scrotum may be helpful in detecting fetal incarcerated inguinoscrotal hernia that may progress to strangulation. If bowel dilatation was observed in such cases, the physician should be alert to identify primary intestinal obstruction caused by congenital digestive tract malformation and secondary intestinal obstruction caused by incarceration.

Foetal inguinoscrotal hernia—its prenatal diagnosis and its spontaneous regression

A foetal inguinoscrotal hernia is a rare abnormality. We report a case of foetal inguinoscrotal hernia diagnosed by ultrasonography at 37 weeks gestation and its spontaneous regression during the perinatal period. The imaging features, differential diagnosis, pregnancy management and outcome are discussed.

Ultrasound prenatal diagnosis of inguinal scrotal hernia and contralateral hydrocele

Fetal inguinal scrotal hernia is a rare condition resulting in an abnormal embryonic process of the tunica vaginalis. We report a case of ultrasound prenatal diagnosis of inguinal scrotal hernia associated with contralateral hydrocele in a woman at 37 weeks of gestation, referred to our clinic for a scrotal mass. Differential diagnosis includes hydrocele, teratoma, hemangiomas, solid tumours of testis, bowel herniation, and testicular torsion. Bowel peristalsis is an important ultrasound sign and it allowed us to make diagnosis of inguinal scrotal hernia. Diagnosis was confirmed at birth and a laparoscopic hernia repair was performed without complications on day 10. During surgery, a bilateral defect of canal inguinal was seen and considered as the cause of scrotal inguinal hernia and contralateral hydrocele observed in utero.

Prenatal Presentation of Inguinoscrotal Hernia

Prenatal diagnosis of inguinal hernia is rare and easily confused with other entities, including masses of the scrotum, abdominal wall, and perineum. Pathologic processes of the scrotum rarely result in enlargement beyond 7 cm. Peristalsis can help to indentify bowel within the mass, suggestive of hernia or omphalocele rather than hydroceles or tumors that contain no bowel. Torsions have a double-ring appearance with no testicular blood flow, whereas hydroceles have visible testicles within a fluid-filled scrotum. Doppler evaluation may be helpful, as hernias typically have minimal vascularity, unlike tumors and teratomas, which are vascular with a widely variable appearance. The authors present the sonographic features of a late-presenting fetal mass that was clinically indistinguishable from omphalocele other than its skin thickness and was larger than typically reported for hernias. Skin thickness and subcapsular fluid are useful adjuncts in distinguishing inguinoscrotal hernia from omphalocele in late gestation.