Prenatal diagnosis of an inguinoscrotal hernia - Sonographic and magnetic resonance imaging findings

The formation of inguinal scrotal hernias is usually aided by factors that act to increase the intra-abdominal pressure, such as vigorous crying, prematurity, chronic lung disease, ascites, and bowel disease in neonates and children.(1) The diagnosis is made by physical examination without difficulty in most cases. However, in the fetus, because physical examination is not possible, and the frequency is probably much less frequent than after birth, the diagnosis of a hernia is more difficult than in the neonate or infant. The clues to diagnosis of an inguinoscrotal hernia in the fetus have been reported as peristaltic movement of herniated bowel and paucity of blood flow on prenatal sonography.(1) We report a case of a fetal inguinoscrotal hernia that appeared as a solid mass by sonographic examination. Contrary to previous reports, the mass had blood vessels in it, and no peristaltic movement was seen during the sonographic examination. The fetal magnetic resonance imaging (MRI) features and outcome of the fetus are also presented.