title: Acute testicular ischemia caused by incarcerated inguinal hernia.
abstract: BACKGROUND
  Acute testicular ischemia caused by an incarcerated inguinal hernia usually affects infants. There are few reports of diagnosis using US, and the effect of long-standing reducible hernias on testicular growth in infants and children is unknown.
  
  
  OBJECTIVE
  The objectives of this study were to determine the incidence of testicular ischemia secondary to an incarcerated inguinal hernia at scrotal sonography and to determine the effect on testicular size at diagnosis.
  
  
  METHODS
  A hospital database was used to locate scrotal sonography examinations documenting an inguinal hernia, and images were reviewed for signs of testicular ischemia. Testicular volumes were compared using the Wilcoxon signed rank test.
  
  
  RESULTS
  A total of 147 patients were identified with an inguinal hernia (age 1 day to 23 years, average 6 years). Ten patients (6.8%) had associated testicular ischemia (age 3 weeks to 6 months, average 9 weeks) and showed a statistically significant increase in ipsilateral testicular size compared to the contralateral testicle (P = 0.012). Patients without testicular ischemia did not show a significant difference in testicular size, regardless of patient age.
  
  
  CONCLUSIONS
  An incarcerated inguinal hernia should be considered as a cause of acute testicular ischemia in infants younger than 6 months of age.
authors.affiliation: Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. rcorth@texaschildrens.org
authors.forename: Robert C
authors.initials: RC
authors.lastname: Orth
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Towbin
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006552:Hernia, Inguinal / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013737:Testis / Q000098:blood supply* / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color; D055815:Young Adult