hydrocele
description
a congenital hydrocele is a collection of fluid in a patent processus vaginalis, an outpouching of the peritoneum extending through the inguinal canal and into the scrotum in the male. in the female it is associated with the round ligament of the uterus in the inguinal canal. a hydrocele may be communicating or non-communicating, and the communicating variety may be associated with inguinal hernia.
diagnosis
prenatal diagnosis of hydrocele has been made in male fetuses by demonstrating presence of fluid in the scrotal sac. if the amount of fluid remains unchanged the hydrocele is most likely non-communicating. if the hydrocele enlarges the communicating variety should be suspected and evaluation in the neonatal period for inguinal hernia is recommended. hydrocele is also sometimes seen in association with fetal hydrops or fetal ascites.
differential diagnosis
it is important to consider the possibility of an inguinal hernia in the presence of a hydrocele. bilateral testicular torsion has been reported to simulate hydrocele in a case report. hydrops, ascites, and other causes of increased intraperitoneal pressure may result in hydrocele secondarily and an underlying cause should always be sought.
sonographic features
fluid in scrotal sac, surrounding testes
fluid in the inguinal canal in female
associated syndromes
- ascites
- hydrops
- chromosomal
- inguinal hernia
- isolated
references
- gross br, cohen hl, schlesser js prenatal diagnosis of bilateral testicular torsion: beware of torsion simulating hydroceles j ultrasound med 12: 479-481
- romero r, pilu f, jeanty p, ghidini a, hobbins jc in: prenatal diagnosis of congenital anomalies appleton & lange: norwalk, p304
- fleischer ac, romero r, manning fa, jeanty p, james jr ae in: the principles and practice of ultrasonography in obstetrics and gynecology appleton & lange: norwalk, p269
- bergsma d in: birth defects compendium alan r liss: new york, p529