G72(P) Another tube in scrotum: an unusual cause of hydrocele

Abstract

Conclusion Regular nitrous oxide abuse causes an active vitamin B12 deficiency; usually total vitamin B12 is normal and more sensitive markers including homocysteine, methylmalonic acid (MMA) and active vitamin B12 are needed for diagnosis. Nitrous oxide abuse is commonplace amongst teenagers and young adults, it is important that paediatricians are made aware of how commonly it is abused and the neurological consequences. Nitrous oxide is cheap and easy to obtain; particularly as it can be bought legally for whipping cream. Those abusing it regard nitrous oxide to be a safe legal high and a thorough drug history is needed to recognise abuse, consideration should also be made for patients requiring recurrent nitrous oxide for medical procedures and pain relief.