Lecture notes for medical students

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2. Definition

3. Definition
• Abnormal collection of serous
fluid between two layers of
Tunica vaginalis.

4. Etiology

5. Etiology
• Congenital
• Primary ?Filaria
• Secondary
1. Epididymorchitis
2. Torsion
3. Tumor
4. Post herniotomy

6. Pathophysiology

7. Pathophysiology
• Excessive production of fluid within the sac
-Secondary hydrocele;
• Defective absorption of fluid
• Interference with lymphatic drainage of
scrotal structures;
• Connection with the peritoneal cavity via a
patent processus vaginalis (congenital
hydrocele.

8. Clinical Features

9. Clinical Features
• Demography
• Symptoms
• Signs
• Prognosis
• Complications

10. Clinical Features:Demography

11. Clinical Features:Demography
• Asia and africa.
• Middle aged.

12. Clinical Features:Symptoms

13. Clinical Features:Symptoms
• C/O- Painless scrotal swelling gradualy
increasing in size.

14. Clinical Features:Signs

15. Clinical Features:Signs
• Oval/ pear shaped
• Rugosities absent
• Local Temp. N
• Tense =/--
• Non tender.
• Skin freely mobile.
• Testis not sepearately palpable
• Get above +nt
• Non reducible

16. Clinical Features:Signs
• Impulse on coughing –nt.
• Dull on percussion.
• Fluctuation +nt.
• Transillumination +nt

17. Clinical Features:Complications

18. Clinical Features:Complications
• Pyocele
• Hemorrhage
• Calcification
• Rupture.

19. Investigations

20. Investigations
• Laboratory Studies
– Routine
– Special
• Imaging Studies USG
• Tissue diagnosis
– Cytology
•FNAC contraindicated
– Histlogy

21. Differential Diagnosis
• Inguinal Hernia
• Encysted hydrocele of cord.
• Testicular tumor.
• Epididymoorchitis.
• Torsion testis
• Filarial scrotum
• Varicocele
• Epididymal cyst
• Pyocele.

22. Differential Diagnosis

23. Management

24. Management
• Eversion of Sac.
– Subdartos pouch (Sharma and Jhawar)
– Lord’s Plication
– Jaboulay’s.
• Excision of sac.

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