morphine and Orchitis

To assess the importance of prenatal ultrasound diagnosis of the fetus carrying meconium periorchitis and its predictive relevance for fetal monitoring and prognosis in the context of acute fetal intestinal disease.. Three male fetuses have been diagnosed of meconium periorchitis in our Unit of Fetal Medicine in the last 5 years. Their prenatal ultrasound diagnoses were: testicular tumor (n=1); Meconium periorchitis with acute fetal intestinal perforation (n=2). Gestational age at diagnosis was 33, 34 and 35 weeks. Ultrasound signs at diagnosis were: Increased size of scrotal zone, with hyperechogenic lesions inside and permanence of peritoneum-vaginal canal; at abdominal zone, echographic signs of intestinal disease with or without meconium peritonitis were found (hyperechogenic lesions, edema of intestinal loops and ascites). All three neonates were assessed postnatally by ultrasound and therapeutic indication.. Fetal ultrasound findings influenced both evolution and termination of pregnancy. The diagnosis of meconium periorchitis was confirmed postnatally in all cases: in the 1st case, delivered at term, scrotal tumoral pathology was ruled out and did not require abdominal surgery; the other 2 patients were delivered at the same week of prenatal diagnosis and an inguinal-scrotal surgery with intestinal approach because of meconium peritonitis was performed. No patient underwent orchiectomy, maintaining the teste-epididymal binomial intact.. Prenatal ultrasound diagnosis of meconium periorchitis requires a strict ultrasound follow-up of the fetus as it is a specific marker of intestinal perforation, which can lead to the termination of pregnancy and avoid appearance of complicated meconium peritonitis.. Evaluar la importancia del diagnóstico ecográfico prenatal del feto portador de periorquitis meconial y su relevancia predictiva del seguimiento y pronóstico fetal en el contexto de una enfermedad intestinal fetal aguda.. En los últimos 5 años en la Unidad de Medicina Fetal se han diagnosticado tres fetos varones de periorquitis meconial cuyos diagnósticos ecográficos prenatales fueron: tumor testicular (n=1); y periorquitis meconial con perforación intestinal aguda fetal (n=2). La edad gestacional al diagnóstico fue de 33, 34 y 35 semanas. Los signos ecográficos al diagnóstico fueron: a nivel escrotal, aumento del tamaño, lesiones hiperecogénicas y permanencia del conducto peritoneo-vaginal; a nivel abdominal pueden existir signos ecográficos de enfermedad intestinal con o sin peritonitis meconial (lesiones hiperecogénicas, edemas de asas y ascitis). Los tres neonatos fueron evaluados postnatalmente mediante ecografía comparativa de los hallazgos prenatales e indicación terapéutica.. Los hallazgos ecográficos fetales influyeron en la evolución y finalización de la gestación. El diagnóstico de periorquitis meconial fue confirmado postnatalmente en los tres casos: en el 1er caso a término, se descartó patología tumoral escrotal y no requirió cirugía abdominal; en los otros dos pacientes se indicó finalizar la gestación tras el diagnóstico prenatal y se realizó cirugía inguino-escrotal y abordaje intestinal por la peritonitis meconial.. El diagnóstico ecográfico prenatal de periorquitis meconial obliga a un seguimiento ecográfico estricto del feto al ser un marcador específico de perforación intestinal, que puede conllevar la finalización de la gestación y evitar la aparición de una peritonitis meconial complicada.

Topics: Adult; Female; Gestational Age; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Orchitis; Pregnancy; Ultrasonography, Prenatal; Young Adult

We present the case of an infant born with scrotoschisis and evidence of meconium periorchitis and peritonitis. A scrotal defect was noted with exposure of the left testis and spermatic cord. Meconium peritonitis and periorchitis were confirmed on operative exploration. Given the history, cystic fibrosis was suspected, but initial screening and diagnostic tests were negative.

Topics: Cystic Fibrosis; Diagnosis, Differential; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Orchiectomy; Orchitis; Peritonitis; Radiography, Abdominal; Scrotum; Testicular Diseases; Testis

Meconium periorchitis (MP) is a rare disorder caused by fetal meconium peritonitis with subsequent spillage of meconium into the scrotal sac. The condition is seldom diagnosed correctly during fetal life and the ultrasonographic diagnoses reported vary from no diagnosis to hematoma or hydrocele. It is usually diagnosed clinically during the first year of life when a scrotal mass is an incidental finding. Here, we describe two cases of MP that were diagnosed during routine intrauterine ultrasound examination for fetal growth assessment, and confirmed after birth. One infant underwent a surgical excision of the scrotal mass, confirming the histological diagnosis of meconium periorchitis. The other was managed conservatively. Neither had cystic fibrosis. Thus, we believe that a diagnosis of MP should be considered when prenatal ultrasonographic findings are suspicious for the problem. The awareness of the ultrasonographer and the neonatologist are important for immediate postnatal management, as congenital scrotal masses may have other etiologies.

Topics: Female; Fetal Diseases; Humans; Infant, Newborn; Male; Meconium; Orchitis; Pregnancy; Testicular Hydrocele; Ultrasonography, Prenatal

Topics: Adolescent; Female; Fetal Diseases; Humans; Male; Meconium; Orchitis; Pregnancy; Ultrasonography, Prenatal

A 10-day-old newborn was taken to the paediatric emergency room due to scrotal swelling. Physical examination showed scrotal enlargement and palpable intrascrotal hard formations. Laboratory blood tests revealed no significant alterations. Testicular ultrasonography showed thickened and hypoechoic scrotal walls and bilateral intrascrotal isoechoic nodules with small internal calcifications. An abdominal X-ray confirmed evidence of bilateral scrotal microcalcifications and small calcifications in the left hypochondrium. Urgent laparotomy performed for scrotal exploration verified the presence of nodular formations on the vaginal tunic of both testicles; the nodules were removed. Bilateral orchidopexy was performed in the same surgical session. When dealing with an acute scrotum in a newborn both emergency radiologists and clinicians should consider the possibility of scrotal meconium pseudocyst as a rare but possible cause of periorchitis.

Topics: Child; Female; Genital Diseases, Male; Humans; Infant, Newborn; Male; Meconium; Orchitis; Scrotum

Topics: Calcinosis; Humans; Infant; Male; Meconium; Orchitis; Scrotum

Durmuş G, Boybeyi-Türer Ö, Gharibzadeh-Hizal M, Ekinci S, Kiper N. Meconium periorchitis: An incidentally diagnosed rare entity during inguinal herniorraphy. Turk J Pediatr 2018; 60: 612-614. Meconium periorchitis (MPO) is a rare disorder caused by meconium peritonitis with the leakage of meconium into the scrotal sac through the patent processus vaginalis. MPO may be rarely detected during inguinal hernia repair. The association of MPO with cystic fibrosis is rarely seen. We present a male infant with the complaint of left groin swelling, compatible with reducible inguinal hernia. An herniotomy was carried out and the greenish nodules with calcifications were detected. Histopathological examination was compatible with MPO. Two months later the patient was diagnosed with atypical cystic fibrosis. Clinicians should be aware of MPO presentations and its appearance on the hernia sac to prevent unnecessary orchiectomy.

Topics: Cystic Fibrosis; Groin; Hernia, Inguinal; Herniorrhaphy; Humans; Incidental Findings; Infant; Infant, Newborn; Male; Meconium; Orchitis; Scrotum

Topics: Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Male; Meconium; Orchitis; Scrotum

Meconium periorchitis is uncommon. In the unborn child the peritoneum vaginal canal is open and, secondary to intestinal perforation due to any cause (intestinal atresia, volvulus, and others), meconium peritonitis occurs. The intestinal content reaches the scrotal vaginal cavity. Meconium peritonitis can heal spontaneously and without consequences. Calcified remnants of this event may remain in the peritoneal cavity and/or scrotum. In the newborn, a hydrocele and scrotal mass can be observed; the ultrasound will show a heterogeneous image with calcifications. Meconium periorchitis or meconium vaginalitis resolves spontaneously. The lack of awareness of this disease could lead to unnecessary surgery in the newborn. We present a 33 days old patient with a scrotal mass in whom surgery was performed with the pathological diagnosis of meconium periorchitis.

Topics: Female; Humans; Infant, Newborn; Male; Meconium; Orchitis; Scrotum

Meconium periorchitis is caused by the leakage of meconium from a bowel perforation into the peritoneal cavity via a patent processus vaginalis into the scrotal sac during fetal life or in the early postnatal period. Intrauterine meconium peritonitis causes sterile inflammatory response and calcification. Here, we describe a prenatally diagnosed case of meconium periorchitis. During the ultrasound scan at 29 weeks' gestation, enlargement of the scrotum with many small hyperechogenic masses and normal anatomy of testis was observed. Our case is the 11th prenatally diagnosed case presented in the worldwide literature and the first one described in Poland. This case confirms the latest tendency for the conservative management of meconium periorchitis and an asymptomatic postnatal course.

Topics: Adult; Conservative Treatment; Female; Fetal Diseases; Humans; Male; Meconium; Orchitis; Poland; Pregnancy; Scrotum; Testis; Ultrasonography, Prenatal

A case of meconium periorchitis detected by fetal MRI and misdiagnosed during pregnancy as inguinoscrotal hernia is reported for the first time. A full-term black boy presented at birth with an asymptomatic, 'stony-hard', scrotal mass suggestive of an in utero testicular torsion or testicular/paratesticular tumor. Early surgical treatment resulted in the removal of paratesticular yellowish amorphous material. Histology was consistent with the diagnosis of meconium periorchitis, a rare and benign condition resulting from healed intrauterine bowel perforation.

Topics: Cysts; Diagnosis, Differential; Female; Hernia, Inguinal; Humans; Infant, Newborn; Intestinal Perforation; Magnetic Resonance Imaging; Male; Meconium; Orchitis; Pregnancy; Prenatal Diagnosis; Scrotum

Topics: Cystic Fibrosis; Female; Fetal Diseases; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Orchitis; Pregnancy; Testicular Hydrocele; Ultrasonography, Prenatal

Topics: Calcinosis; Humans; Infant; Male; Meconium; Orchitis; Scrotum; Ultrasonography

We report a 9-month-old boy who presented with a hard paratesticular mass. Clinical and ultrasound findings were highly suggestive of malignancy and orchidectomy was performed. Histology confirmed the unexpected diagnosis of meconium periorchitis, a rare, benign condition resulting from intrauterine bowel perforation.

Topics: Diagnosis, Differential; Humans; Infant; Male; Meconium; Orchiectomy; Orchitis; Scrotum; Testis; Ultrasonography

Topics: Follow-Up Studies; Humans; Infant, Newborn; Male; Meconium; Orchiectomy; Orchitis; Risk Assessment; Ultrasonography, Doppler, Color

Two cases of meconium periorchitis respectively in a ten-day- and a five-month-old infant are reported. The presenting symptom was a scrotal mass, isolated in one case and associated with pain and inflammation in the other case. Intraoperative histological diagnosis allowed conservative surgery in one case.. About 40 cases of scrotal manifestations of an intrauterine perforation of the gastrointestinal tract are reported in the literature. In cases with associated intraperitoneal calcifications, the diagnosis is easy and surgical exploration may be avoided, spontaneous resolution being the rule. However, in half of the cases, a scrotal mass is the only manifestation and raises the question of a testicular tumor.. Unfamiliarity with this unusual entity may lead to unnecessary orchiectomy.

Topics: Diagnosis, Differential; Humans; Infant; Infant, Newborn; Male; Meconium; Orchiectomy; Orchitis; Peritonitis; Remission, Spontaneous; Testicular Neoplasms

Meconium periorchitis (MPO) is an uncommon entity associated with healed meconium peritonitis. The typical presentation is soft hydrocele at birth which becomes harder in weeks as the meconium calcifies. It mimics a scrotal mass, and, without knowledge of this rare disease, this may lead to unnecessary surgery. Both the masses and the calcifications have the tendency to resolve spontaneously without compromising the testicle. Sonographic features together with an abdominal plain film are diagnostic, and visualization of the normal testicle may be helpful in differentiating this tumor-like lesion from scrotal tumors. A case of a meconium periorchitis is reported on and the radiological and histological features are discussed with a literature review on the subject.

Topics: Calcinosis; Diagnosis, Differential; Follow-Up Studies; Humans; Infant; Infant, Newborn; Male; Meconium; Orchitis; Scrotum; Tomography, X-Ray Computed; Ultrasonography

Scrotoschisis, a congenital defect of the scrotal wall associated with extracorporeal testicular ectopy, has been previously reported only twice. Meconium periorchitis is another rare scrotal anomaly indicative of an antenatally healed gastrointestinal perforation. The authors present a third case of scrotoschisis and the first associated with meconium periorchitis. Several hours after birth of an otherwise-normal term baby boy, a scrotal exploration was performed with orchidopexy and primary closure of the scrotal wall defect. At 4 months of age the baby underwent a contralateral inguino-scrotal exploration with excision of a paratesticular mass of calcified meconium. The role of a normally developed scrotum in testicular descent and causes of calcified scrotal masses in infants are discussed.

Topics: Humans; Infant, Newborn; Male; Meconium; Orchitis; Scrotum; Testis

Topics: Calcinosis; Cryptorchidism; Diagnosis, Differential; Humans; Infant; Male; Meconium; Orchitis

Topics: Calcinosis; Child, Preschool; Diagnosis, Differential; Genital Diseases, Male; Humans; Male; Meconium; Orchitis; Scrotum; Ultrasonography

Perforation of the bowel wall in utero, with meconium gaining access to the tunica vaginalis, results in meconium periorchitis. The clinical and pathologic features in four infants were studied; the findings were compared with those in the 20 cases reported in the literature. In the majority of cases, the intestinal perforation had apparently healed before birth, and the scrotal mass became increasingly obvious following birth. Cystic fibrosis was documented in only one case. A yellowish green paratesticular mass with multifocal dystrophic calcification was the principal gross finding. Lobules of fibromyxoid tissue containing the calcifications were separated by bands of connective tissue. A granulomatous reaction per se was not prominent in the four cases of the present study, although some authors have characterized the process as meconium granuloma. Before orchiectomy is performed in an infant with a scrotal mass, the possibility of meconium periorchitis should be considered.

Topics: Calcinosis; Hernia, Inguinal; Humans; Infant; Infant, Newborn; Male; Meconium; Orchiectomy; Orchitis; Scrotum; Testicular Hydrocele; Testis

Topics: Female; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Orchitis; Peritonitis; Pregnancy

Topics: Calcinosis; Diagnosis, Differential; Humans; Infant; Infant, Newborn; Male; Meconium; Orchitis