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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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