URORADIOLOGY


Case 7 :
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A 55-year-old male presents with a right-sided inguino-scrotal swelling of 6 months duration. USG pictures are available for diagnosis.


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Imaging Findings
Ultrasound images of the inguino-scrotal region reveal a cystic, loculated fluid collection, which stops short at the level of the epididymis. No tunica vaginalis hydrocele is noted. Testes and epididymis show normal size and echopattern. No other abnormal echoes suggestive of bowel or omentum was noted in this collection.

 

Diagnosis
Encysted hydrocele of cord

Discussion
Fluid collections of a serous character are very frequently found in the scrotum. To these the term hydrocele is applied. The most common form is the ordinary vaginal hydrocele, in which the fluid is contained in the sac of the tunica vaginalis, which is separated, in its normal condition, from the peritoneal cavity by the whole extent of the inguinal canal.

In another form, the congenital hydrocele, the fluid is in the sac of the tunica vaginalis, but this cavity communicates with the general peritoneal cavity, its tubular process remaining pervious.

A third variety known as an infantile hydrocele, occurs in those cases where the tubular process becomes obliterated only at its upper part, at or near the abdominal inguinal ring. It resembles the vaginal hydrocele, except as regards its shape, the collection of fluid extending up the cord into the inguinal canal.

Fourthly, the funicular process may become obliterated both at the abdominal inguinal ring and above the epididymis, leaving a central unobliterated portion, which may become distended with fluid, giving rise to encysted hydrocele of the cord.

 

Contribution
Dr. Sanjeev Mani, Mumbai