Why is there a ball of intestines in the scrotum?

A lump of intestine in the scrotum may be a symptom of an indirect inguinal hernia or hydrocele, which is usually caused by factors such as congenital weakness of the abdominal wall and increased intra-abdominal pressure, and may be accompanied by a feeling of distension or pain. It is recommended to seek medical treatment promptly for a clear diagnosis.

1. Indirect inguinal hernia

Indirect inguinal hernia is a common disease in which abdominal contents protrude into the scrotum through the inguinal canal. It may be related to factors such as underdevelopment of the abdominal wall muscles, increased abdominal pressure caused by long-term cough or constipation. The typical manifestation is a reducible mass in the scrotum, which can be retracted into the abdominal cavity when lying down and protrude when standing or exerting force. Strenuous exercise needs to be avoided and a hernia band can be used for temporary fixation, but surgical repair is the radical method, such as laparoscopic hernia repair or open tension-free hernia repair.

2. Hydrocele

Hydrocele is a condition in which abdominal fluid flows into the scrotum due to the failure of the sheath to close. It manifests as painless swelling of the scrotum and a positive light transmission test. Primary hydrocele is more common in infants and young children and may be related to delayed development of the lymphatic system ； Secondary effusion can be caused by orchitis, trauma, etc. A small amount of effusion can be observed, but a large amount of effusion requires sheath inversion or sheath resection.

3. Testicular torsion

The rotation of the spermatic cord during testicular torsion leads to blood circulation disorder, which may be caused by strenuous exercise or congenital testicular mesangial length. Sudden severe pain and swelling in the scrotum are typical symptoms and may be mistaken for intestinal prolapse. Emergency surgical reduction and fixation is required within 6 hours, otherwise testicular necrosis may occur. Ultrasound examination can confirm the diagnosis, and hot compress is prohibited.

4. Varicocele

When the spermatic vein return is blocked, the tortuous venous plexus in the scrotum may form a mass-like structure, which is more common on the left side. The feeling of bloating is obvious after standing for a long time, which is relieved by lying down. Severe varicose veins may affect fertility and require high spermatic vein ligation. For mild cases, you can wear tight underwear to support your scrotum and avoid standing for long periods of time.

5. Testicular tumors

When testicular tumors grow rapidly, they may appear as a hard mass in the scrotum, which is often painless. Malignant tumors such as embryonal carcinoma and teratoma may be accompanied by retroperitoneal lymph node enlargement. Tumor marker detection and imaging examinations can assist diagnosis. Radical orchiectomy is the main treatment method, and postoperative radiotherapy and chemotherapy are combined according to the pathological type.

In daily life, you need to avoid lifting heavy objects, holding your breath, exerting force, and other behaviors that increase abdominal pressure, and choose loose and breathable cotton underwear. Observe changes in the size of the mass and whether it is accompanied by redness, swelling, heat and pain. If there is persistent pain, vomiting or the mass cannot be recovered, emergency treatment is required immediately. Keep the wound clean and dry after surgery, conduct regular ultrasound examinations to assess recovery, and avoid straddling for 3 months.