Hydrocele
Background
Scrotal anatomy
Scrotal anatomy
- 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
Differential Diagnosis
Testicular Diagnoses
- Scrotal cellulitis
- Epididymitis
- Fournier gangrene
- Hematocele
- Hydrocele
- Indirect inguinal hernia
- Inguinal lymph node (Lymphadenitis)
- Orchitis
- Scrotal abscess
- Spermatocele
- Tinea cruris
- Testicular rupture
- Testicular torsion
- Testicular trauma
- Testicular tumor
- Torsion of testicular appendage
- Varicocele
- Pyocele
- Testicular malignancy
- Scrotal wall hematoma
Evaluation
- +Transillumination
- Consider testicular ultrasound
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
References
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