Sonography of scrotal masses in healed meconium peritonitis

Abstract

Although sonography is the procedure of choice in evaluating testicular masses in infants, x-ray examination can confirm the diagnosis of healed meconium peritonitis by showing scattered intra-abdominal as well as intrascrotal calcifications. Failure to include an abdominal radiograph early in the evaluation of 2 infants admitted with hard scrotal masses resulted in delayed diagnosis of healed meconium peritonitis. The clinical progression of meconium peritonitis involving the scrotum starts with soft hydroceles at birth and progresses, as the meconium calcifies, to hard “tumor-like” masses at age 4–5 weeks. This paper stresses the sonographic characteristics of meconium peritonitis in the scrotum and the need for confirming radiographs of the abdomen.