Testicular ischemia as a result of an incarcerated inguinal hernia containing omentum: a two-case series

Acute scrotal pain is a very common presentation to the emergency room. The most important pathology we must exclude is testicular infarction or testicular ischemia. Here we describe two rare cases of acute scrotum where incarcerated inguinal hernias containing omentum resulted in testicular ischemia/infarction. In Case 1, we describe a rare case in an adult where a large, incarcerated hernia containing omentum along with direct trauma to the testicle resulted in testicular infarction. In Case 2, we describe a 2-year-old boy who presented with left scrotal tenderness due to a left inguinal hernia containing omentum resulting in compromised testicular blood flow. Both patients underwent scrotal exploration. This article also explores the possible pathophysiology of how omentum containing hernias may result in an increased risk of testicular ischemia.