Acute swelling and discoloration of scrotum in new born can have many localized causes like testicular torsion, inguinal hernia, scrotal or testicular edema, hydrocele, or even remote causes like adrenal hemorrhage. We report a neonate of adrenal hemorrhage presenting clinically as acute scrotum misguiding the clinician to rule out a local scrotal pathology. As the local clinical examination is not reliable in a newborn, it definitely requires an imaging evaluation to establish the diagnosis. This case report emphasizes being aware of the clinical association of acute adrenal hemorrhage and an acute scrotum and the role of ultrasonography in the evaluation of the various differential diagnoses leading to an acute scrotum. An optimum sonographic examination helps in suspecting an abdominal pathology as a cause of acute scrotum and in establishing the specific diagnosis of adrenal hemorrhage to avoid an unnecessary surgical exploration.

Dorsal agenesis of the pancreas is a rare entity, with about 100 cases reported. It can be overlooked on ultrasound due to the non visualization of the body and tail of the pancreas. This is due to overlying gas in the stomach, which offers a poor acoustic window and obscures visualization. Renal agenesis and Mullerian duct anomalies are uncommon associations of dorsal agenesis of the pancreas because of the separate embryological origin of the pancreas and genitourinary organs. Here, we present a case of a 17-year-old patient who had dorsal agenesis of the pancreas, associated with unilateral renal agenesis, unicornuate uterus, and ectopic ovary. We describe the anomalies and discuss the radiological differential diagnosis and potential pitfalls. We provide a brief review of the literature with few radiological teaching points and possible genetic implications of the case.

No abstract