Post-herniotomy Ischemic Orchitis in a Child: A Silent Threat.

Ischemic orchitis is an uncommon but potentially serious complication of pediatric inguinal hernia repair. Although most postoperative alterations in testicular blood flow are transient, persistent ischemia may progress to infarction and testicular loss. Doppler ultrasonography is the key diagnostic tool for early recognition. Awareness of this rare complication, careful surgical technique, and prompt evaluation of postoperative scrotal symptoms are essential to optimize outcomes and preserve testicular viability in children undergoing herniotomy. We report a six-year-old boy who developed acute scrotal pain and swelling following elective right herniotomy. Doppler ultrasound revealed markedly reduced intratesticular blood flow consistent with ischemic orchitis. Despite initial conservative management, progressive ischemia necessitated scrotal exploration, which revealed a non-viable testis requiring orchiectomy.