# Penoscrotal Edema as a Rare Complication of Acute Pancreatitis: A Case Report

## TL;DR

A young man with acute pancreatitis developed rare penoscrotal swelling, which improved with treatment and highlights the need for awareness of this unusual complication.

## Contribution

This case report documents a rare instance of penoscrotal edema as a complication of acute interstitial edematous pancreatitis in a young male.

## Key findings

- Penoscrotal swelling was observed in a patient with acute interstitial edematous pancreatitis.
- CT scans showed dilated scrotal veins associated with the pancreatitis.
- The penoscrotal swelling significantly reduced by the time of discharge.

## Abstract

Background and Objectives: Scrotal swelling or hydrocele is a rare complication of acute pancreatitis described in the literature. We present a case of penoscrotal swelling caused by the first attack of acute interstitial edematous alcohol-induced pancreatitis in a young male patient. Case report: A 22-year-old man was admitted to the emergency unit due to diarrhea and vomiting since morning which was followed by severe abdominal pain. Urgent abdominal multislice CT scan showed steatosis, pancreatic swelling and acute peripancreatic fluid collection (interstitial edematous pancreatitis). Also, scan showed fluid between small bowel loops and along the anterior renal fascia, while there was minimal amount of fluid in the Douglas space. There was no sign of penoscrotal swelling. On the second day of admission, the patient developed left scrotal swelling and mild pain without erythema. On the fourth day, a control CT scan showed progression to moderately severe pancreatitis (CT severity index 4). Dilated scrotal veins of the pampiniform venous plexus with an increased caliber of the testicular veins were present on both sides, from the scrotum to the level of the inguinal canal. Penoscrotal swelling was significantly reduced on discharge. Conclusions: Penoscrotal swelling is a rare complication or manifestation of acute inflammation of the pancreas. It is important to identify scrotal swelling caused by pancreatitis because in severe cases it can be related to possible infertility in the future.