Management of pediatric pyocele using percutaneous imaging-guided aspiration

Earl Y. Cheng; Daniel T. Oberlin

doi:https://doi.org/10.21985/N23764

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Management of pediatric pyocele using percutaneous imaging-guided aspiration

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INTRODUCTION: Pyocele of the scrotum is a rare clinical entity not well-described in the pediatric liter-ature. With the exception of those patients who cannot undergo surgery, all published cases have beentreated definitely with surgical drainage with severe cases leading to orchiectomy.PRESENTATION OF CASE: A 12 day-old full-term boy with no significant medical history presented tothe emergency department with a two-day history of fever, right hemiscrotal redness, swelling anddiscomfort. Scrotal ultrasound revealed findings consistent with an acute pyocele of the tunica vaginalisalso known as an infected hydrocele. The infection was successfully managed with ultrasound-guidedtranscutaneous aspiration under local anesthesia.DISCUSSION: To the best of our knowledge, this is the first description of percutaneous aspiration of infantpyocele Pediatric patients diagnosed with acute pyocele require immediate urologic evaluation, with aconsideration for surgical exploration and drainage. Unfortunately, orchiectomy may be required at thetime of surgical exploration in severe cases. Percutaneous drainage is a non-operative, minimally invasivetreatment modality that avoids orchiectomy and the risks of general anesthesia.CONCLUSION: Percutaneous drainage avoids open surgical exploration, expedites recovery, and is per-formed in the absence of general anesthesia in select cases.

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