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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 extends freely between scrotum & peritoneal cavity via patent processus vaginalis
            • Noncommunicating hydrocele: No connection between scrotum & peritoneal cavity → implies closed processus vaginalis
            • Spermatic cord hydrocele: Fluid in inguinal canal
              • 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: Girls only → localized fluid collection in groin &/or labia majora
              • Also called female hydrocele
            • 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

                                1. Williamson ZC et al: Imaging of the inguinal canal in children. Curr Probl Diagn Radiol. 42(4):164-79, 2013
                                2. Khanna PC et al: Sonographic appearance of canal of Nuck hydrocele. Pediatr Radiol. 37(6):603-6, 2007
                                3. Lau ST et al: Current management of hernias and hydroceles. Semin Pediatr Surg. 16(1):50-7, 2007
                                4. 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 extends freely between scrotum & peritoneal cavity via patent processus vaginalis
                                          • Noncommunicating hydrocele: No connection between scrotum & peritoneal cavity → implies closed processus vaginalis
                                          • Spermatic cord hydrocele: Fluid in inguinal canal
                                            • 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: Girls only → localized fluid collection in groin &/or labia majora
                                            • Also called female hydrocele
                                          • 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

                                                              1. Williamson ZC et al: Imaging of the inguinal canal in children. Curr Probl Diagn Radiol. 42(4):164-79, 2013
                                                              2. Khanna PC et al: Sonographic appearance of canal of Nuck hydrocele. Pediatr Radiol. 37(6):603-6, 2007
                                                              3. Lau ST et al: Current management of hernias and hydroceles. Semin Pediatr Surg. 16(1):50-7, 2007
                                                              4. Rathaus V et al: Ultrasound features of spermatic cord hydrocele in children. Br J Radiol. 74(885):818-20, 2001