Scrotal hematocele

Last revised by Dr Jeremy Jones on 20 Sep 2021

Scrotal hematoceles are collections of blood within the scrotal sac, but outside of the testis.

A hematocele normally results from trauma to the scrotum, or on occasion following surgery. Some think that a varicocele is a risk factor for developing a hematocele 4.

Ultrasound is usually the sole imaging modality used, typically being first line for those with a scrotal swelling or pain following trauma to the scrotum. Unlike a hydrocele, which is anechoic, a hematocele is of increased echogenicity and often has septa within. If the ultrasonographic investigation is performed right after the event, a fresh hematocele can appear anechoic, though some turbulence will occasionally be seen within it.

A clinical differential would be for a scrotal wall hematoma.

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Cases and figures

  • Case 1
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  • Case 2: hematocele with testicular rupture
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