Emergency Ultrasound > Top 10 Pathology > Hydrocele


Hydrocele is defined as fluid surrounding the testicle, which is usually simple, anechoic and without layering debris (Fig 3a, 3b). If septations, significant layering or debris are visualized during scanning, then diagnosis of a complex hydrocele is made and either pyocele or hematocele are considered (Fig 3c). Tumor rupture into the tunica vaginalis can also produce a complex hydrocele. Hydroceles are fairly commonly visualized in testicular sonography and are secondary to many different abnormalities. Simple anechoic fluid can be seen in a patient with congenital abnormalities, (such as a patent processus vaginalis), and ascites for any metabolic reason. It can also be seen after inflammation, infection or torsion. Blood in the tunica vaginalis can be seen after trauma, tumor rupture or surgery. A pyocele is usually associated with infection, likely from a non-treated epididymo-orchitis.

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Fig 3 a. Transverse view hydrocele, b. Sagittal view hydrocele, c. Hematocele.

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