HAROLD O. CONN
Sudden, massive scrotal edema may occasionally occur after paracentesis in ascitic, cirrhotic patients. This syndrome is caused by the creation of a fistula between the peritoneal cavity and the subcutaneous tissues, with dissection of ascitic fluid between Camper's and Scarpa's fasciae downward into the continuous tissues of the scrotum. Variations of the syndrome occur in noncirrhotic patients with ascites of other causes, in women (sudden labial edema), and in the absence of paracentesis in patients who develop communications between the peritoneal and subcutaneous spaces (spontaneous scrotal edema). The distribution of edema depends on the site of paracentesis and the effect of gravity, for example, abdominal wall edema in supine patients, unilateral abdominal wall edema in patients who prefer lateral decubitus positions, and upper abdominal wall edema (Trendelenburg's position) and chest wall edema after thoracentesis. These syndromes may be avoided by using small needles and by avoiding skin sutures.
CONN HO. Sudden Scrotal Edema in Cirrhosis: A Postparacentesis Syndrome. Ann Intern Med. ;74:943–945. doi: 10.7326/0003-4819-74-6-943
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© 2019
Published: Ann Intern Med. 1971;74(6):943-945.
DOI: 10.7326/0003-4819-74-6-943
Gastroenterology/Hepatology, Liver Disease.
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