Download CASE # 3

Amaro.Amolenda.Anacta
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A 35-year old male comes to your clinic with
the following problem of 10 years duration.
Except for the mass, he is relatively
asymptomatic.
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HYDROCELE
Collection of serous fluid that results from a defect or irritation in
the tunica vaginalis of the scrotum
 Adult hydroceles are usually late-onset (secondary). Late-onset
hydroceles may present acutely from local injury, infections, and
radiotherapy; they may present chronically from gradual fluid
accumulation. Morbidity may result from chronic infection after
surgical repair. Hydrocele can adversely affect fertility.
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Clinical Manifestation:
•
•
Most hydroceles are asymptomatic or subclinical*
The patient may report a sensation of heaviness, fullness, or
dragging.

TESTICULAR TORSION
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Testicular torsion occurs when a testicle rotates on the
spermatic cord, which provides blood flow to the testicle*
Testicular torsion is most common in males under 25, but it can
occur at any age, including in newborns and infants.
Clinical Manifestation:
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Sudden or severe pain in one testicle
Swelling of the scrotum (a loose bag of skin under your penis that
contains your testicles)
Nausea and vomiting
Abdominal pain
Fever

ORCHITIS

Orchitis is an acute inflammatory reaction of the testis
secondary to infection. Most cases are associated with a
viral mumps infection; however, other viruses and
bacteria can cause orchitis.
Clinical Manifestation:
• Testicular swelling on one or both sides
• Pain ranging from mild to severe
• Tenderness in one or both testicles
• Nausea
• Fever
• Discharge from penis
• Blood in semen

INGUINAL HERNIA
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Inguinal hernias occur when soft tissue, usually part
of the intestine protrudes through a weak point or
tear in the lower abdominal wall. *
Some inguinal hernias have no apparent cause. But
many occur as a result of: (1) Increased pressure
within the abdomen, (2) A pre-existing weak spot in
the abdominal wall, (3) A combination of the two*
Clinical Manifestation
A bulge in the area on either side of your pubic bone
 Pain or discomfort in your groin, especially when
bending over, coughing or lifting
 A heavy or dragging sensation in your groin
 Occasionally, in men, pain and swelling in the
scrotum around the testicles when the protruding
intestine descends into the scrotum
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Enlarged, non tender scrotum
Testicles cannot be palpated
If there’s an associated inguinal hernia, pressure
on the abdomen or scrotum will enlarge or shrink
the fluid-filled sac
Transillumination
 shine a flashlight at the swollen area of the scrotum
 the light will show the outline of the testicle, indicating
a clear fluid surrounding it
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often used to confirm the diagnosis of hydrocele as it
provides excellent detail of the testicular
parenchyma
rule out a tumor, torsion, spermatocele or other
conditions
if a testicular tumor is a diagnostic consideration,
ultrasonography is an excellent screening study
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Plain radiography may be useful for distinguishing
an acute hydrocele from an incarcerated hernia
Gas overlying the groin may indicate an incarcerated
hernia.