Vasitis: a rare diagnosis mimicking inguinal hernia: a case report

Abstract

Background Vasitis or inflammation of the vas deferens is a rare condition, and few case reports with computed tomography images have been published since 1980. Case presentation A 50-year-old man presented with severe right inguinal and lower abdominal pain. Initial diagnosis at the emergency department was incarcerated or strangulated inguinal hernia. The computed tomography scan revealed diffuse edematous changes of right spermatic cord and vas deferens with peripheral fat stranding. Correlating with his clinical symptoms, signs, and imaging findings, the diagnosis of vasitis was made. We report a case of acute vasitis about the cause, symptom, pathogen, differential diagnoses, image findings, and treatment. Conclusion Although very rare, vasitis should be listed as one of the differential diagnosis for inguinal mass lesions. Cross-sectional imaging may be necessary to confirm the diagnosis and exclude differentials such as an inguinal hernia. Recognition of the characteristic image findings can help to make the correct diagnosis and avoid unnecessary surgery.

Vasitis Nodosa: A Rare Diagnosis for Inguinal Swelling

“…This proliferation of epithelium results in luminal occlusion of vas deferens with increased intraluminal pressures causing leakage of spermatozoa and subsequent granuloma formation and fibrosis [ 3 , 4 ]. Most cases have a previous history of vasectomy or surgeries in close proximation of vas deferens, such as herniorrhaphy, perianal fistulectomy, or prostatectomy [ 5 ]. Vasitis nodosa has been reported in 66% of patients who had undergone vasectomy [ 1 , 6 ].…”

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

“…Since then, there have been 10 cases to date confirmed on CT imaging 2,3,5–9 . Two cases had ultrasound reporting an inguinal hernia prior to vasitis being confirmed on CT scan 2,3 .…”

“…CT or magnetic resonance imaging are the suggested imaging modalities to confirm vasitis 2 . A CT scan for vasitis characteristically shows a thickened and oedematous unilateral spermatic cord without an inguinal hernia containing bowel 8 …”

“…2 A CT scan for vasitis characteristically shows a thickened and oedematous unilateral spermatic cord without an inguinal hernia containing bowel. 8 None of the 10 cases record positive non-STI urine culture, despite urinary pathogens being the suspected cause. 1 Two case reports that were taken to theatre record positive tissue culture for non-haemolytic streptococci and Escherichia coli.…”

“…Since then, there have been 10 cases to date confirmed on CT imaging. 2,3,[5][6][7][8][9] Two cases had ultrasound reporting an inguinal hernia prior to vasitis being confirmed on CT scan. 2,3 CT or magnetic resonance imaging are the suggested imaging modalities to confirm vasitis.…”