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Old 02-16-2011
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Zygote Infant Scrotal Enlargement pathophysiology and embryology

A 5-month-old Caucasian male is brought to your office by his mother who noticed right-sided scrotal enlargement. On ultrasonography, the enlargement is found to be a fluid collection around the right testis. This patient’s condition has pathophysiology most similar to which of the following?


A. Femoral hernia
B. Direct inguinal hernia
C. Indirect inguinal hernia
D. Acute orchitis
E. Acute testicular torsion
F. Hypospadia
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Old 02-16-2011
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indirect inguinal hernia
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Old 02-16-2011
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indirect inguinal hernia

both can hav defective closure of processus vaginalis(a peritoneal fold which descends with testis through deep inguinal ring)
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Old 02-16-2011
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C. Indirect inguinal hernia
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Old 02-16-2011
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Default C.

Agreed - indirect inguinal hernia. Both hydrocele and indirect inguinal hernia usually result from patency of processus vaginalis, and they may co-exist.

*NB: hydrocele can be secondary to orchitis or testicular torsion
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Old 02-16-2011
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Arrow C) Indirect inguinal hernia

Ans Is C) Indirect inguinal hernia

Infant Scrotal Enlargement pathophysiology and embryology-ighern.jpg
click image to enlarge

Failure of obliteration of the processus vaginalis leads to a persistent connection between the scrotum and the peritoneal cavity through the inguinal canal. If the opening is small and allows for fluid leakage only hydrocele occurs. Diagnosis is by translumination of the scrotum and scrotal ultrasound, which reveal fluid (only) in the tunica vaginalis sac.

Infant Scrotal Enlargement pathophysiology and embryology-inguinalhernia.jpg
click image to enlarge

If the communication between the peritoneal cavity and the scrotum allows for the passage of abdominal organs, an indirect inguinal hernia develops. A bulge on the groin that increases during straining is the typical manifestation.
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Tags
Embryology-, Figures-, Pathology-, Pediatrics-, Reproductive-, Step-1-Questions

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