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What Causes Right Groin Pain And Very Dark Discolored Scrotal Sac?

Posted on Mon, 12 Jan 2015

Question: A 54 yr old white male c/o. right groin pain and a very dark discolored scrotal sac. Sitting intensifies the pain. No diarrhea, constipation or indigestion. Moving the left hip with a bent knee toward the right leg intensifies the pain. Bending over also intensifies the pain. The pain is intermittent. No fever, no chills, no c/o pain or burning with urination. Could this be a possible hernia or a groin muscle pull?

Answered by Dr. Deepak Kishore Kaltari (6 minutes later)

Brief Answer:
Likely to be groin muscle pull

Detailed Answer:
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Dear Sir

Going by description of pain aggravated by movements of hip joint , the cause is more likely to be groin mumuscle pull.

Also possibility of Hernia can't be ruled out without thorough physical examination. It would be very helpful if you could provide me with the following additional information

1. Is there any swelling in right groin or scrotal region especially after act which increases intrabdominal pressure like coughing or sneezing

2. Are there any urinary complaints ?

3.is there any discrepancy in size of scrotum on right side ad compared to left side .

Awaiting your response

Take care

Best regards
Dr Deepak Kaltari
Consultant Surgeon

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Deepak Kishore Kaltari (21 minutes later)

There is no swelling in the groin or scrotal region. No complaints of burning or pain with urination. Upon initial exam the right testicle was higher than the left but immediately fell back into place. When deeply palpating the right groin there seems to be a bunch, lump or tightening of a muscle or tendon in that area. I am concerned with the extreme color change in the scrotal sac itself. It is so dark it almost looks black in color and this color follows from the bottom of the scrotal sac almost to the anus. This problem actually originated on Monday, Dec. 22nd. However, at that time the pain was in the right lower quadrant and has since moved into the groin.

Answered by Dr. Deepak Kishore Kaltari (5 minutes later)

Brief Answer:
Get Ultrasound / Color Doppler scan

Detailed Answer:
Dear Sir

If following criteria are fulfilled it is unlikely to be testicular pathology

1. Testis normal in lie and location

2. Testis is firm and non tender

3. Testicular sensation normal

4. Cremasteric reflex normal and comparable on both sides

5. No local rise of temperature

The palpable things in groin is likely to be lymph nodes. Acute inflammation of either spermatic cord or lymph nodes could cause it.

To be on safer side get Ultrasound and color Doppler to rule out any possible testicular pathology missed on clinical examination.

Apart from it possibility of fungal infection needs to be considered if there are no other acute signs of inflammation in scrotum. Do provide me clinical photograph for further assessment.

Awaiting your response

Take care

Best regards
Dr Deepak Kaltari

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Above answer was peer-reviewed by : Dr. Ashwin Bhandari