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Hydrocele
From WikEM
Contents
Background
- Accumulation of fluid around the testis
- Most common cause of painless scrotal swelling in children
- Secondary to persistent processus vaginalis
- Most are right sided
- Most resorb by 18-24 months of age
- Acute symptomatic hydroceles are not benign, require workup
Evaluation
- +Transillumination
- Consider testicular ultrasound
Differential Diagnosis
Testicular Diagnoses
- Testicular torsion
- Epididymitis
- Orchitis
- Torsion of testicular appendage
- Scrotal abscess
- Fournier gangrene
- Hydrocele
- Indirect inguinal hernia
- Hematocele
- Spermatocele
- Testicular trauma
- Testicular rupture
- Varicocele
- Inguinal lymph node (Lymphadenitis)
- Testicular tumor
- Cellulitis
- Tinea cruris
Management
- None indicated
Disposition
- Referral to urologist
- Hydroceles that persisted >1 year or in patients >18 months should undergo ultrasonography to rule out tumor vs inflammatory etiology
