Scrotal hydroceles

Case contributed by Dennis Odhiambo Agolah
Diagnosis certain

Presentation

Patient presenting with nocturia and swelling of the scrotum for about one year, left greater than right. No history of trauma.

Patient Data

Age: 70 years
Gender: Male
ultrasound

Both testes are within the scrotal sac. Significant scrotal sacs free fluid collection (hydroceles) that is predominantly anechoic but with subtle fine echoes floating intrinsically is noted. The right scrotal sac fluid totals 31.01 ml while the left amounts to 107.80 ml in volume. No tenderness elicited over the scrotum on graded sonopalpation.

The testicles demonstrates homogeneous parenchymal echo/vascular pattern.

Small sized parenchymal soft tissue extensions/ nodular protuberances at the bilateral epididymal heads seen is consistent with epididymal appendices1. A multilocular small, thin-walled left epididymal head cyst is noted as well.

Case Discussion

Bilateral scrotal sac hydroceles which allow better visualization of epididymal head appendices and a small left epididymal head cyst.

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