title: Scrotal Abscess: A Rare Presentation of Complicated Necrotizing Pancreatitis.
abstract: Acute pancreatitis is characterized by activation of digestive enzymes inside the pancreas. In severe pancreatitis, necrosis of pancreas and surrounding tissues may occur. Acute necrotizing pancreatitis commonly presents as pancreatic abscess occasionally with systemic complications. Rarely, necrotic tissue may be drained from scrotum due to retroperitoneal extension of necrotic process. Here, we report a case of acute necrotizing pancreatitis in a 29-year-old man who presented with severe abdominal pain, nausea and vomiting. A computerized tomography (CT) scan confirmed necrotizing pancreatitis with multiple abscesses spreading bilaterally in the pelvic cavity. Several surgical operations were performed, including necrosectomy and drainage. Subsequently, the patient developed a scrotal abscess, which was drained surgically. The patient's condition was complicated by pleural effusion, acute respiratory distress syndrome, colocutaneous and scrotal fistulas, and incisional hernia. It seems that the scrotal abscess is a very rare complication of necrotizing pancreatitis.
authors.affiliation: Assistant Professor of General Surgery, Clinical Research Development Center of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Seyyedhadi
authors.initials: S
authors.lastname: Mirhashemi
authors.affiliation: Assistant Professor of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Soori
authors.affiliation: Resident of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Gholamhossein
authors.initials: G
authors.lastname: Faghih
authors.affiliation: Associate Professor of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Peyvandi
authors.affiliation: Researcher Associate of Clinical Research Development Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Omid
authors.initials: O
authors.lastname: Shafagh
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology / Q000601:surgery*; D000328:Adult; D004322:Drainage; D006801:Humans; D008297:Male; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery*; D010996:Pleural Effusion; D011183:Postoperative Complications; D012128:Respiratory Distress Syndrome; D012187:Retroperitoneal Space / Q000601:surgery; D012611:Scrotum / Q000382:microbiology* / Q000473:pathology; D014057:Tomography, X-Ray Computed