Occult Splenic Rupture Presenting as Acute Scrotal Swelling

Abstract Background: Scrotal pain and swelling is a common complaint encountered in emergency medicine. The differential diagnosis includes testicular, scrotal, and intra-abdominal pathology. Case Report: We present a case of an 80-year-old man on warfarin therapy presenting with acute atraumatic sc...

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Bibliographic Details
Published in:The Journal of emergency medicine 2012-09, Vol.43 (3), p.438-441
Main Authors: Huckins, David S., MD, Barnett, Tara, MS, PAC
Format: Article
Language:English
Subjects:
Aged, 80 and over
Edema - etiology
Emergency
Erythrocyte Transfusion
hematocele
Hematocele - diagnosis
Hematocele - etiology
hemoperitoneum
Humans
Indexing in process
Male
Pain - etiology
Plasma
processus vaginalis
Rupture, Spontaneous
Scrotum
spleen
Splenectomy
Splenic Rupture - diagnosis
Splenic Rupture - surgery
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Summary:Abstract Background: Scrotal pain and swelling is a common complaint encountered in emergency medicine. The differential diagnosis includes testicular, scrotal, and intra-abdominal pathology. Case Report: We present a case of an 80-year-old man on warfarin therapy presenting with acute atraumatic scrotal pain and swelling initially diagnosed as a hydrocele. The diagnosis was subsequently determined to be a communicating hematocele secondary to occult splenic rupture. Conclusion: Intra-abdominal pathology can result in scrotal pain and swelling due to passage of intra-abdominal contents into the scrotum via a patent processus vaginalis. Therefore, any cause of hemoperitoneum may also cause hematocele and hematocele should be considered in the differential diagnosis of acute scrotal swelling in any patient with risk factors for bleeding. In these patients, both scrotal and abdominal imaging should be considered.
ISSN:0736-4679
2352-5029
DOI:10.1016/j.jemermed.2010.04.017