Monday, March 30, 2009

Hydrocele


2 1/2 year old boy presented with swelling of his left scrotum. Ultrasound showed fluid within his scrotal sac consistent with hydrocele. The lower image showed patent inguinal canal or hydrocanal. This is consistent with communicating hydrocele.
Hydroceles are caused by the accumulation of fluid in the scrotum. It can either be unilateral or bilateral. In most cases, the condition is congenital, or present at birth.
There are 2 types - communicating and non-communicating.The former is due to failure of processus vaginalis to close soon after birth. This type of hydrocele is typically bigger in the evening and smaller, or absent, in the morning as the fluid often returns to the abdomen due to hours of being recumbent.
Non-communicating hydroceles occur when fluid stays inside a closed sac and is not gradually absorbed into the body. Most hydrocele in adult men are non-communicating hydroceles as a result of an infection or injury to the scrotal area, or if blood or fluid becomes blocked inside the spermatic cord. Most, however, seem to occur for no apparent reason.

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