Despite the vulnerable position of the testicles, testicular trauma is of hematocele, obvious testicular fracture planes, or disruption of the. Scrotal haematocoeles are collections of blood within the scrotal sac, but outside of the testis. Pathology A haematocele normally results from trauma to the. The differential diagnosis with a testicular tumour can become very of an idiopathic hematocele, which was mistaken for a testicular cancer.

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Testicular germ-cell cancer [published correction appears in Lancet. A retrospective review of pediatric patients with epididymitis, testicular torsion, and torsion of testicular appendages. Diagnosis and classification of inguinal hernias.

It is an abnormal collection of serous fluid located between the visceral and parietal layers of the tunica vaginalis, but also may be adjacent to the spermatic cord. In the literature, only a few cases of idiopathic, chronic haematoceles are reported. The final diagnosis was hematocele.

The strange case of a hematocele mistaken for a neoplastic scrotal mass

T2-weighted image demonstrates areas of hypersignal and marked hyposignal compatible with hemoglobin at different phases of degradation. Hematocele after laparoscopic appendectomy. Anaerobic and gas-producing bacteria, including those of the Clostridium genus are the main etiological agents of such a condition 3.

When testicular torsion is suspected, emergent surgical consultation should be obtained before ultrasonography is performed, because surgical exploration as soon as possible is critical to salvaging the testis and should not be delayed for imaging unless the diagnosis is in doubt.


At US, hematoceles appear as heterogeneous encapsulated extra testicular solid mass separated by septations and loculations3,4,11, B-mode US image of a two-month-old infant. Scrotal ultrasound of 29 year old baseball player found to have ITH with intact tunica albuginea.

Bowen and Christopher M. Theoretically, in neonates, all hydroceles are congenital and associated with a patent vaginal process that allows the passage of peritoneal fluid into the scrotum Figure 4.

Pyocele Most frequently, pyocele occurs as a complication of orchiepidydimitis, particularly in cases where the latter crosses the mesothelial layer of hematocels tunica vaginalis 3or secondarily to a reactive infected hydrocele 6.

The postoperative course was uneventful, and the patient was discharged on postoperative day 2. A clinical differential would be for a scrotal wall hematoma.

It is defined as accumulation of blood within the tunica vaginalis. The mechanism underlying the expansion of such hematomas is still unclear.

In the following years it reached gigantic size.

Torsion of the testis is most common in males 10 to 25 years of age. Anatomic relationships and pathologic conditions.

A varicocele is a dilation of the pampiniform venous plexus along the spermatic cord. Testicular carcinomas are more gradual in onset; the testis will be nontender on examination. Orchitis is usually viral in origin, subacute in onset, and may be accompanied by systemic illness.


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The patient usually presents with a soft nodule in the head of the epididymis. During fetal development, the processus vaginalis testis forms as an extension of the peritoneum, descending into the scrotum and surrounding the testis.

Sign up for the free AFP email table of contents. In the pediatric age range, hematocele may also be secondary to abdominal traumas 8. Can Urol Trsticular J.

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This article has been cited by other articles in PMC. Color Doppler ultrasonography is the test of choice for immediate evaluation of scrotal masses.

All patients underwent at least one scrotal ultrasound reviewed by the same urologist. Typically, at MRI, abscesses present hyposignal on T1- and hypersignal on T2-weighted sequences, which is characteristic of fluid contents, with a halo of hypersignal on T2-weighted sequences.

Septations and calculi may also be identified. Figure 1 Gross photograph of the left hemiscrotal mass. A persistent processus vaginalis may lead to a hydrocele or an indirect inguinal hernia.