Stuart Kesler

MECONIUM PEARLS IN THE SCROTUM

A 9-month-old boy presented with several firm masses in the left hemiscrotum discovered 2 weeks previously. He was the product of an unremarkable full-term pregnancy. The mother was also concerned with the appearance of the uncircumcised penis, which had become progressively less apparent with noticeable ballooning of the foreskin and prepenile skin during voiding. Physical examination demonstrated a buried penis as well as several nontender firm masses in the left hemiscrotum. The remainder of the examination was unremarkable. Preoperatively scrotal ultrasound showed several spherical hyperechoic masses with shadowing in the left hemiscrotum (fig. 1). The masses were mobile and consistent with the diagnosis of meconium pearls. Screening abdominal ultrasound was normal. The patient underwent penile degloving and buried penis repair. The tunica vaginalis was opened and several spherical masses consistent with meconium pearls were removed (fig. 2). Subsequently standard left inguinal exploration was performed with high ligation of the patent processus vaginalis. Convalescence was unremarkable. Normal sweat chloride test results ruled out cystic fibrosis.