MECONIUM-INDUCED PERIORCHITIS – INTERESTING CASE CONSTELLATION OUT OF PEDIATRIC SURGERY f.meyer@med.ovgu.de

PE041

MECONIUM-INDUCED PERIORCHITIS – INTERESTING CASE CONSTELLATION OUT OF PEDIATRIC SURGERY

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Germany

Poster Exhibition only

A testicular tumor-like lesion or a solid extratesticular mass are serious postnatal problems with a broad spectrum of inflammatory or tumorous causes and possible differential diagnoses.

Using a case report, an extraordinary case of a male newborn with a rare cause of a periorchitis is described.

(case description) A premature male infant (25-year-old mother with obesity) was diagnosed to have a disturbance of prosperity. Plain film of the abdomen showed a dilated intestine (no pathological findings in abdominal ultrasound, in particular, no ascites). After 3 postanatal 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 operation for the right and left hydrocele. The testes could be preserved (follow-up investigation, no further problems).

Pathohistologic investigation confirmed meconium periorchitis, which is a rare postnatal disease and which can only develop in case of former meconium peritonitis and if the processus vaginalis peritonei is open. The main problem is not the local inflammation but rather the inflammatorily caused uncharacteristic changes of the surrounding tissue and calcifications, which can mimic a tumor lesion in imaging and may subsequently lead to a disturbance of the growth of testes in case of longer persistence. The precise knowledge of cause and pathophysiology may significantly help to avoid unnecessary orchiectomy.