A Single-Center Study on Clinico-Radiological Evaluation of Inguino-Scrotal or Labial Swellings Presenting to a Tertiary Care Set-Up in Central India

Abstract

Introduction The inguino-scrotal/labial region, anatomically defined as the juncture where the thigh meets the lower abdomen, encompassing the ipsilateral scrotal area in men and the inguino-labial area in women, exhibits a broad spectrum of masses. Traditionally, these swellings were clinically diagnosed with high accuracy, primarily due to the prevalence of simple hernias and hydroceles. However, contemporary observations reveal a surge in complex inguino-scrotal/labial swellings, particularly in referral hospitals, necessitating additional radiological and imaging modalities for precise diagnosis. Our interest in this subject was sparked by the escalating numbers of intricate inguino-scrotal/labial masses encountered in our medical setting, posing challenges for clinical diagnosis in both pediatric and adult populations. Materials and methods A prospective, observational study was conducted over two years (August 2021 to March 2023) involving 210 patients presenting with inguino-scrotal/labial swellings at our institute. Clinical data were meticulously collected using a designed pro forma, following informed consent procedures. Results Among the 210 patients with inguino-scrotal/labial swellings, males predominated (194) compared to females (16). The paediatric age group comprised 84 patients, while 126 were adults. Radiological investigations played a crucial role in diagnosing 40 patients and provided significant additional information in 12 cases. Radiological investigations contributed to the diagnosis in 52 patients (24.76%). The study revealed a spectrum of new entities in the inguino-scrotal/labial region, including malignancies, lymph nodal masses in the groin, and vascular, inflammatory, and congenital lesions, which might have been overlooked if solely relying on clinical parameters for diagnosis. Conclusion Inguino-scrotal/labial swelling patients, especially those facing diagnostic dilemmas or harbouring complex lesions, should undergo radiological assessment as an indispensable criterion, particularly when such facilities are readily accessible.

Keywords: groin; inguino-labial; inguino-scrotal; radiology; swelling.

Figure 1. Right Amyand's hernia with caecum, appendix, the undescended testis and omentum as its content.

Age: 32 years, sex: male.

Figure 2. Giant right recurrent inguinal hernia immediately post-operation along with ultrasound images done on the same patient.

(A, B) Gross appearance of recurrent inguinal hernia immediately post-operation; (C, D) ultrasound images of recurrent inguinal hernia immediately post-operation. Age: 42 years, sex: male.

Figure 3. Inguinal hernia along with Fournier's gangrene.

Age: 33 years, sex: male.

Figure 4. Scrofuloderma of inguinal region.

Age: 36 years, sex: male.

Figure 5. Inguinal lymph nodal secondaries from carcinoma of the anal canal.

Age: 38 years, sex: male.