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Massive penoscrotal haematoma following inguinal hernia repair: a case report.

Shah DK, Sagar J - J Med Case Rep (2008)

Bottom Line: As with other surgical procedures, this is also associated with possible complications.Eventually he recovered well, although slowly.We strongly emphasize the importance of adequate control of bleeding, even in small to moderate sized inguinal hernias in order to avoid such disastrous complications with long-term cosmetic disfigurement.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Surgery and Interventional Science, Royal Free and University College Medical School, Hampstead Campus, London, UK. drdkshah2000@yahoo.co.in

ABSTRACT

Introduction: Inguinal hernia is one of the commonest surgical conditions that one comes across in a surgical career. Operative repair is the only successful treatment for hernias. As with other surgical procedures, this is also associated with possible complications. Scrotal haematoma is one of the well-known complications following hernia repair, but massive penoscrotal haematoma requiring surgical intervention is very rare.

Case presentation: A 53-year-old black man had undergone elective hernia repair. He underwent standard open hernia repair with a prolene mesh and developed massive scrotal haematoma which required drainage. Eventually he recovered well, although slowly.

Conclusion: To achieve adequate bleeding control during and at the end of operation is the key preventive measure to avoid scrotal haematoma. Here, we report a case of massive penoscrotal haematoma following repair of a moderate sized inguinal hernia. We strongly emphasize the importance of adequate control of bleeding, even in small to moderate sized inguinal hernias in order to avoid such disastrous complications with long-term cosmetic disfigurement.

No MeSH data available.


Related in: MedlinePlus

Massive penoscrotal haematoma following inguinal hernia repair. The drain is placed in the main wound following exploration of the right inguinal wound.
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Figure 1: Massive penoscrotal haematoma following inguinal hernia repair. The drain is placed in the main wound following exploration of the right inguinal wound.

Mentions: A 53-year-old black man had been admitted for elective right inguinal hernia repair and excision of a lipoma from his back at one of the private hospitals in London. He was fit and healthy without any medical problems. He had undergone open repair of a moderate-sized right inguinal hernia with a prolene mesh and excision of the lipoma from his back under general anaesthetic without any intra-operative complications. After the two hour operation, he complained of pain at the operative site. Examination of the local area revealed a massive penoscrotal haematoma. As he was stable haemodynamically, he underwent wound exploration under general anaesthesia. The bleeding spurts within the hernia wound were stopped and the wound was closed with a Radivac drain. A urethral catheter was inserted in the postoperative period as he could not pass urine. He was started on oral augmentin as prophylaxis. On the first postoperative day, his haemoglobin dropped to 7.1 gm% so he was given 2 units of blood. The drain had released about 20 ml of blood. On the second postoperative day, he was still in pain. Local examination revealed a massive penoscrotal haematoma (Figure 1) with no change in its size. He had further drainage of the scrotal haematoma under local anaesthesia and 200 ml of blood was evacuated. The wound was closed with a corrugated drain. The patient was investigated thoroughly by a haematologist and all blood investigations including coagulation profile, Factor XI bioassay, PFA-100 platelet function tests, vWF:antigen assay and vWF:collagen binding were normal. The drain was removed on the fourth postoperative day and the patient was discharged on augmentin. On a follow-up visit after 2 weeks, the patient was doing well without any complaints although with cosmetic disfigurement.


Massive penoscrotal haematoma following inguinal hernia repair: a case report.

Shah DK, Sagar J - J Med Case Rep (2008)

Massive penoscrotal haematoma following inguinal hernia repair. The drain is placed in the main wound following exploration of the right inguinal wound.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2599901&req=5

Figure 1: Massive penoscrotal haematoma following inguinal hernia repair. The drain is placed in the main wound following exploration of the right inguinal wound.
Mentions: A 53-year-old black man had been admitted for elective right inguinal hernia repair and excision of a lipoma from his back at one of the private hospitals in London. He was fit and healthy without any medical problems. He had undergone open repair of a moderate-sized right inguinal hernia with a prolene mesh and excision of the lipoma from his back under general anaesthetic without any intra-operative complications. After the two hour operation, he complained of pain at the operative site. Examination of the local area revealed a massive penoscrotal haematoma. As he was stable haemodynamically, he underwent wound exploration under general anaesthesia. The bleeding spurts within the hernia wound were stopped and the wound was closed with a Radivac drain. A urethral catheter was inserted in the postoperative period as he could not pass urine. He was started on oral augmentin as prophylaxis. On the first postoperative day, his haemoglobin dropped to 7.1 gm% so he was given 2 units of blood. The drain had released about 20 ml of blood. On the second postoperative day, he was still in pain. Local examination revealed a massive penoscrotal haematoma (Figure 1) with no change in its size. He had further drainage of the scrotal haematoma under local anaesthesia and 200 ml of blood was evacuated. The wound was closed with a corrugated drain. The patient was investigated thoroughly by a haematologist and all blood investigations including coagulation profile, Factor XI bioassay, PFA-100 platelet function tests, vWF:antigen assay and vWF:collagen binding were normal. The drain was removed on the fourth postoperative day and the patient was discharged on augmentin. On a follow-up visit after 2 weeks, the patient was doing well without any complaints although with cosmetic disfigurement.

Bottom Line: As with other surgical procedures, this is also associated with possible complications.Eventually he recovered well, although slowly.We strongly emphasize the importance of adequate control of bleeding, even in small to moderate sized inguinal hernias in order to avoid such disastrous complications with long-term cosmetic disfigurement.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Surgery and Interventional Science, Royal Free and University College Medical School, Hampstead Campus, London, UK. drdkshah2000@yahoo.co.in

ABSTRACT

Introduction: Inguinal hernia is one of the commonest surgical conditions that one comes across in a surgical career. Operative repair is the only successful treatment for hernias. As with other surgical procedures, this is also associated with possible complications. Scrotal haematoma is one of the well-known complications following hernia repair, but massive penoscrotal haematoma requiring surgical intervention is very rare.

Case presentation: A 53-year-old black man had undergone elective hernia repair. He underwent standard open hernia repair with a prolene mesh and developed massive scrotal haematoma which required drainage. Eventually he recovered well, although slowly.

Conclusion: To achieve adequate bleeding control during and at the end of operation is the key preventive measure to avoid scrotal haematoma. Here, we report a case of massive penoscrotal haematoma following repair of a moderate sized inguinal hernia. We strongly emphasize the importance of adequate control of bleeding, even in small to moderate sized inguinal hernias in order to avoid such disastrous complications with long-term cosmetic disfigurement.

No MeSH data available.


Related in: MedlinePlus