Persistent scrotal swelling after laparoscopic inguinal hernia repair: “Omentaloma of the scrotum”

Complete removal of all the contents of a hernial sac is crucial in laparoscopic inguinal hernia repair. We report a case who underwent transabdominal preperitoneal repair for a complete, irreducible inguinal hernia. He had persistent scrotal swelling and new onset scrotal pain post‐surgery. Ultraso...

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Bibliographic Details
Published in:Asian journal of endoscopic surgery 2021-04, Vol.14 (2), p.279-281
Main Authors: Bhattacharjee, Hemanga Kumar, Singla, Vitish, Nariampalli Karthyarth, Mithun, Parshad, Rajinder
Format: Article
Language:English
Subjects:
Hernias
inguinal hernia
Laparoscopy
scrotal swelling
TAPP
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Summary:Complete removal of all the contents of a hernial sac is crucial in laparoscopic inguinal hernia repair. We report a case who underwent transabdominal preperitoneal repair for a complete, irreducible inguinal hernia. He had persistent scrotal swelling and new onset scrotal pain post‐surgery. Ultrasonography of the scrotum revealed a well‐defined hypoechoic scrotal lesion. A magnetic resonance imaging revealed a fat‐containing mass lesion, hypointense on T2 fat‐saturated image. He underwent exploration of the scrotum and a well‐encapsulated mass was excised. The histopathological evaluation revealed a well‐encapsulated structure comprising of lobules of fibroadipose tissue with foci of chronic inflammation and foamy histiocytes likely retained omentum from previous surgery. His scrotal pain disappeared post‐excision. A missed retained omentum in the hernial sac causes considerable anxiety to patients and diagnostic and therapeutic dilemmas for the treating surgeon. We coined the term “omentaloma of the scrotum” for such a lesion.
ISSN:1758-5902
1758-5910
DOI:10.1111/ases.12846