Plugoma: CT findings after prosthetic plug inguinal hernia repairs.

BACKGROUND: Unrecognized CT findings of a prosthetic plug used in inguinal hernia repair can lead to incorrect diagnosis or unnecessary workup of a patient. The objective of this study is to review the expected CT findings present in patients with a history of plug repair. STUDY DESIGN: Retrospective cohort study retrieving clinical and image data from a single-institution database. Patients who underwent prosthetic plug hernia repair during a 5-year period at our institution had their records queried for subsequent abdominal CT scans. These CT scans were reviewed by 2 radiologists for findings referable to the hernia repair. RESULTS: Five-hundred and sixty-four consecutive patients underwent prosthetic plug hernia repair during a 5-year period. Fifty-one patients who had had 55 surgical procedures had subsequent CT scans, none in the early postoperative period. Readers identified 100% of the plugs, 68% of which were described as round or oval in shape. All the plugs were in close proximity to the inferior epigastric artery and were of low density on CT images. Surgical scar was identifiable in 87% of patients. Thirty-two patients (63%) had a second CT scan, demonstrating no change in size and location of the plugoma. CONCLUSIONS: A prosthetic mesh plug is easily seen on CT images, typically appearing as a smooth round or oval hypodense mass close to the inferior epigastric artery, deep to a surgical scar, and stable over time. It can usually be distinguished from pathologic findings. It is important that the radiologist be familiar with the patient's surgical history when interpreting these images.

MR imaging of scrotal tumors and pseudotumors.

Magnetic resonance (MR) imaging is an important imaging technique in the evaluation of scrotal masses, providing a useful adjunct to ultrasonography (US). Although US is the modality of choice for initial evaluation of scrotal pathologic conditions because of its wide availability, low cost, and high sensitivity for detection of testicular and paratesticular disease processes, US findings may occasionally be inconclusive. MR imaging may provide additional information in these cases, often affecting patient management. This article reviews and illustrates the MR imaging features of solid extratesticular and intratesticular benign and malignant scrotal tumors, as well as nonneoplastic lesions that can mimic neoplasia. Normal scrotal MR anatomic features and optimal MR imaging technique are also presented.