Sexually transmitted infective vasitis mimicking left inguinal hernia: computed tomography clarifies diagnosis

Matthews, Samuel J.; Tyson, Matthew; Lauti, Melanie; Zargar, Kamran

doi:10.1111/ans.15957

Cited by 2 publications

(3 citation statements)

References 8 publications

(34 reference statements)

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“…Possible pathogens include Escherichia coli and Haemophilus influenzae [ 7 ]. Sexually-transmitted infections [ 4 ] and infections due to Chlamydia trachomatis [ 8 ] have also been reported. Rare pathogens such as Mycobacterium tuberculosis and Brucella have also been isolated [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, few published papers have reported on the diagnosis of vasitis using CT scans since the previous approach to diagnosis was based only on ultrasound assessment. In a typical CT scan of vasitis [ 3 , 4 , 15 – 18 ], edematous changes over the spermatic cord and surrounding fat stranding are usually observed. Since contrast enhancement is dependent on the density of vessels, CT scans of inguinal hernias tend to enhance the bowel wall (peripheral predominance).…”

Section: Discussionmentioning

confidence: 99%

“…Previously, sonography was used for diagnosis, but its sensitivity and specificity were not clarified. Some studies have suggested that a computed tomography (CT) scan should be used for a definitive diagnosis whenever the sonography report is equivocal [ 4 ]. However, fat stranding between the spermatic cords can mimic an incarcerated bowel loop on a CT scan, making it difficult to obtain a correct diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Misdiagnosis of vasitis: a potential diagnostic pitfall with computed tomography

Huang

et al. 2022

Basic Clin. Androl.

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Background Vasitis is a rare condition that may be challenging for the clinical practitioner. Sometimes it is misdiagnosed as incarcerated inguinal hernia; thus, patients end up receiving unnecessary surgery. Compared with the traditional approach with only sonography, the more recent introduction of computed tomography in the diagnostic process has provided higher quality imaging and more detailed anatomy. Consequently, some urologists advocate the efficacy of computed tomography in the differential diagnosis of difficult cases. Case presentation We present the case of a 23-year-old male who suffered from right inguinal pain and swelling. His scrotum ultrasound showed multiple tubular structure dilatation within the subinguinal area and no testis torsion. The initial diagnosis was a right inguinal hernia. Computed tomography supported that initial diagnosis, and we presumed the lesion represented a herniation of the omentum with mesenteric vessels. Since there was a suspicion of hernia incarceration, the patient underwent diagnostic laparoscopy, which did not reveal herniation, but only erythematous reaction and swelling over the right spermatic cord. Following a final diagnosis of vasitis, he received empirical antibiotic treatment and his symptoms entirely resolved. Conclusions Even though computed tomography can provide thorough imaging of the urogenital system, the contrast enhancement within vessels and inflammatory organs can still be misleading in the diagnostic process.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Misdiagnosis of vasitis: a potential diagnostic pitfall with computed tomography

Huang

et al. 2022

Basic Clin. Androl.

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Pelvic lipomatosis presenting with chronic vasitis: a case report

Natarajan¹,

Pattnaik²,

Viswaroop³

et al. 2022

Afr J Urol

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Background Vasitis is a rare condition and has not been reported in the literature in association with pelvic lipomatosis. Case presentation 25-year-old young male presented with bilateral scrotal pain. He was found to have bilateral thickened and tender vas. On further evaluation, he was diagnosed with pelvic lipomatosis and dilated vas up to ejaculatory duct. He was treated with anti-inflammatory medication and is on close follow-up to look for further symptoms related to other luminal compressive pathologies that are known to occur with pelvic lipomatosis. Conclusion In patients with pelvic lipomatosis, careful examination of genitalia is necessary to look for other compressive findings including vasal obstruction and vasitis.

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Sexually transmitted infective vasitis mimicking left inguinal hernia: computed tomography clarifies diagnosis

Cited by 2 publications

References 8 publications

Misdiagnosis of vasitis: a potential diagnostic pitfall with computed tomography

Misdiagnosis of vasitis: a potential diagnostic pitfall with computed tomography

Pelvic lipomatosis presenting with chronic vasitis: a case report

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