Journal of Postgraduate Medicine
 Open access journal indexed with Index Medicus & ISI's SCI  
Users online: 5475  
Home | Subscribe | Feedback | Login 
About Latest Articles Back-Issues Article Submission Resources Sections Etcetera Contact
 
  NAVIGATE Here 
  Search
 
  
 RESOURCE Links
 ::  Similar in PUBMED
 ::  Search Pubmed for
 ::  Search in Google Scholar for
 ::  Article in PDF (419 KB)
 ::  Citation Manager
 ::  Access Statistics
 ::  Reader Comments
 ::  Email Alert *
 ::  Add to My List *
* Registration required (free) 

  IN THIS Article
 ::  References
 ::  Article Figures

 Article Access Statistics
    Viewed2349    
    Printed98    
    Emailed2    
    PDF Downloaded14    
    Comments [Add]    

Recommend this journal


 


 
  Table of Contents     
CASE SNIPPET
Year : 2011  |  Volume : 57  |  Issue : 4  |  Page : 339-340

A diagnostic dilemma: Arteriovenous malformation of spermatic cord presenting as irreducible inguinal swelling


1 Department of General Surgery, Lokmanya Tilak Municipal Medical College and Hospital, Mumbai, Maharashtra, India
2 Department of Pathology, Lokmanya Tilak Municipal Medical College and Hospital, Mumbai, Maharashtra, India

Date of Web Publication22-Nov-2011

Correspondence Address:
M Gadhire
Department of General Surgery, Lokmanya Tilak Municipal Medical College and Hospital, Mumbai, Maharashtra
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0022-3859.90090

Rights and Permissions




How to cite this article:
Joshi M A, Gadhire M, Dhake A, Patil M. A diagnostic dilemma: Arteriovenous malformation of spermatic cord presenting as irreducible inguinal swelling. J Postgrad Med 2011;57:339-40

How to cite this URL:
Joshi M A, Gadhire M, Dhake A, Patil M. A diagnostic dilemma: Arteriovenous malformation of spermatic cord presenting as irreducible inguinal swelling. J Postgrad Med [serial online] 2011 [cited 2019 Nov 18];57:339-40. Available from: http://www.jpgmonline.com/text.asp?2011/57/4/339/90090


Arteriovenous malformation (AVM) in the spermatic cord is a rare condition. We are presenting a case of right inguinal irreducible swelling diagnosed clinically as an irreducible inguinal hernia but intraoperatively found to be an inflammatory mass. On histopathologic evaluation, the mass was diagnosed to be an AVM.

A 25-year-old male patient presented in the emergency with painful, irreducible swelling in the right inguinal region since 3 days. The patient had history of vomiting, but no distension of abdomen, constipation or obstipation. There was no history of fever. On clinical examination, the patient had an irreducible swelling in the right inguinal region. The swelling was tender with warmth and redness over the overlying skin. The cough impulse was negative. On per-abdominal examination, there was no tenderness or guarding over the abdomen. There was no hyperperistalsis. X-ray abdomen showed no significant findings. Due to the presence of acute irreducible inguinal swelling with a clinical suspicion of irreducible hernia, decision was taken to explore the patient. On exploration of the right inguinal region, there was a firm mass of spermatic cord, which was edematous and inflamed. There was no hernial sac. So, the decision was taken to excise the mass. The mass was separate from the vas and testicular artery and we were able to preserve the vas along with artery and few veins. Postoperatively, the patient was stable and was discharged on day 3. The histopathology report was suggestive of AVM [Figure 1].
Figure 1: Microscopic photograph of histopathology of the excised right inguinal swelling is suggestive of arteriovenous malformation of the spermatic cord

Click here to view


AVM is an abnormal connection between veins and arteries. This pathology is widely known because of its occurrence in the central nervous system, but can appear in any location. AVMs involving the spermatic cord are uncommon as opposed to AVMs located in the Central Nervous System. AVMs of the spermatic cord are benign lesions consisting of complex tangles of enlarged dilated arteries and veins without the intervening capillaries. Spermatic cord AVM has been reported for recurrent testicular pain. [1] Spermatic cord AVMs presenting as paratesticular swelling or incidental findings in a patient of infertility have also been reported. [2],[3] To our knowledge, spermatic cord AVM presenting as irreducible tender swelling in the inguinal region has not been reported in the literature.

In our case, the patient had presented in the emergency with acute symptoms suggestive of irreducible inguinal hernia, so emergency exploration was carried out. But the diagnosis of AVM of spermatic cord was made only on the basis of histopathology report. So, from this experience, we should keep in mind that AVM of spermatic cord can be one of the differential diagnoses of irreducible inguinal swellings.

 
 :: References Top

1.Sountoulides P, Bantis A, Asouhidoy I, Aggelonidou H. Arteriovenous malformation of the spermatic cord as the cause of acute scrotal pain: A case report. J Med Case Reports 2007;1:110  Back to cited text no. 1
    
2.McCracken JM, MacNeil AE, Mueller D, Magee F. Ultrasound features of a paratesticularavm: A Case report of an 11 year old boy. Pediatr Radiol 2005;35:532-4.  Back to cited text no. 2
    
3.Monoski MA, Gonzales RR, Thomas AJ, Goldstein M. Arteriovenous malformation of scrotum causing virtual azoospermia. Urology 2006;68:203.  Back to cited text no. 3
    


    Figures

  [Figure 1]



 

Top
Print this article  Email this article
 
Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow