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Pediatrics
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Genitourinary
Scrotal/Testicular Abnormalities
Variations of Hydroceles
Variations of Hydroceles
Ethan A. Smith, MD
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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Definitions
Hydrocele: Abnormal fluid in scrotal tunica vaginalis &/or spermatic cord/inguinal canal
Communicating hydrocele: Fluid connects freely between scrotum & peritoneal cavity via patent processus vaginalis
Noncommunicating hydrocele: No connection between scrotum & peritoneal cavity
Implies closed processus vaginalis
Encysted hydrocele: Loculated fluid in inguinal canal with no connection to scrotum or peritoneal cavity
Funicular hydrocele: Fluid in inguinal canal with connection to peritoneal cavity (via open internal ring)
Abdominoscrotal hydrocele: Loculated, dumbbell-shaped fluid collection with abdominal & scrotal components
More frequent in adolescents & adults
Hydrocele of canal of Nuck: Females only → localized fluid collection in groin &/or labia majora
Complex hydrocele: Complicated fluid, which may be due to blood (hematocele) or pus (pyocele)
Older children, usually with history of trauma, infection, testicular torsion, or malignancy
IMAGING
General Features
Ultrasonographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
DIAGNOSTIC CHECKLIST
Reporting Tips
Selected References
Funatsu Y et al: Laparoscopic abdominoscrortal hydrocele: a case series. Urology. 145:236-42, 2020
Alkhori NA et al: Pediatric scrotal ultrasound: review and update. Pediatr Radiol. 47(9):1125-33, 2017
Costantino E et al: Abdominoscrotal hydrocele in an infant boy. BMJ Case Rep. 2017, 2017
Williamson ZC et al: Imaging of the inguinal canal in children. Curr Probl Diagn Radiol. 42(4):164-79, 2013
Khanna PC et al: Sonographic appearance of canal of Nuck hydrocele. Pediatr Radiol. 37(6):603-6, 2007
Lau ST et al: Current management of hernias and hydroceles. Semin Pediatr Surg. 16(1):50-7, 2007
Rathaus V et al: Ultrasound features of spermatic cord hydrocele in children. Br J Radiol. 74(885):818-20, 2001
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Definitions
Hydrocele: Abnormal fluid in scrotal tunica vaginalis &/or spermatic cord/inguinal canal
Communicating hydrocele: Fluid connects freely between scrotum & peritoneal cavity via patent processus vaginalis
Noncommunicating hydrocele: No connection between scrotum & peritoneal cavity
Implies closed processus vaginalis
Encysted hydrocele: Loculated fluid in inguinal canal with no connection to scrotum or peritoneal cavity
Funicular hydrocele: Fluid in inguinal canal with connection to peritoneal cavity (via open internal ring)
Abdominoscrotal hydrocele: Loculated, dumbbell-shaped fluid collection with abdominal & scrotal components
More frequent in adolescents & adults
Hydrocele of canal of Nuck: Females only → localized fluid collection in groin &/or labia majora
Complex hydrocele: Complicated fluid, which may be due to blood (hematocele) or pus (pyocele)
Older children, usually with history of trauma, infection, testicular torsion, or malignancy
IMAGING
General Features
Ultrasonographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
DIAGNOSTIC CHECKLIST
Reporting Tips
Selected References
Funatsu Y et al: Laparoscopic abdominoscrortal hydrocele: a case series. Urology. 145:236-42, 2020
Alkhori NA et al: Pediatric scrotal ultrasound: review and update. Pediatr Radiol. 47(9):1125-33, 2017
Costantino E et al: Abdominoscrotal hydrocele in an infant boy. BMJ Case Rep. 2017, 2017
Williamson ZC et al: Imaging of the inguinal canal in children. Curr Probl Diagn Radiol. 42(4):164-79, 2013
Khanna PC et al: Sonographic appearance of canal of Nuck hydrocele. Pediatr Radiol. 37(6):603-6, 2007
Lau ST et al: Current management of hernias and hydroceles. Semin Pediatr Surg. 16(1):50-7, 2007
Rathaus V et al: Ultrasound features of spermatic cord hydrocele in children. Br J Radiol. 74(885):818-20, 2001
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