Rare disease

Meconium-induced periorchitis

Hardy Krause¹, Hans-Juergen Hass¹, Ludwig von Rohden², Steffen Kroker¹, Peter Buhtz³, Anja Jaekel¹, Frank Meyer⁴

¹ University Hospital, Magdeburg (Germany), Division of Pediatric Surgery, Department of Surgery, Leipziger Strasse 44, Magdeburg, 39120, Germany
² University Hospital, Magdeburg (Germany), Division of Pediatric Radiology, Department of Radiology and Nuclear Medicine, Leipziger Strasse 44, Magdeburg, 39120, Germany
³ University Hospital, Magdeburg (Germany), Institute of Pathology, Leipziger Strasse 44, Magdeburg, 39120, Germany
⁴ University Hospital, Department of Surgery, Leipziger Strasse 44, Magdeburg, 39120, Germany

Correspondence to:
Frank Meyer, frank.meyer{at}med.ovgu.de

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.

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