Pediatric Hydrocele

  • Etiology: Aberrant closure of the processus vaginalis leading to patent processus vaginalis resulting in fluid between visceral and parietal layers of the tunica vaginalis
  • Imaging: Simple appearing fluid confined to scrotum and surrounding the testicle
  • DDX: Hydrocele of spermatic cord
  • Complications:
  • Treatment: Surgical repair
  • Clinical: Most are congenital in young males

Radiology Cases of Hydrocele

US of hydrocele
Transverse and sagittal US of the right scrotum (above) shows a large anechoic fluid collection around the right testicle and epididymis. Sagittal US of the left scrotum (below) for comparison shows no fluid collection around the normal appearing left testicle.
US of bilateral hydroceles
Transverse (above) and sagittal (below) US of the scrotum shows a small amount of anechoic simple fluid around the right testicle and a large amount of anechoic simple fluid around the left testicle.
US of hydrocele
Sagittal US of the left scrotum (above) is unremarkable while sagittal US of the right scrotum (below) shows a large anechoic fluid collection surrounding the right testicle.
US of hydrocele
Sagittal color and spectral doppler US of the left (above) and right (below) testicles show an anechoic fluid collection around the left testicle. There is normal flow to both testicles.
CT of testicular hematoma
Axial CT with contrast of the abdomen (above) shows a heterogenous appearance to the enlarged right testicle which is surrounded by an edematous scrotal sac. Sagittal US of the right scrotum (below) again shows the thickened edematous scrotal sac, the heterogenous testicle, and an anechoic fluid collection surrounding the testicle.

Radiology Cases of Hydrocele and Testicular Microlithiasis

US of testicular microlithiasis
Sagittal US of the left testicle (above) shows multiple punctate calcifications throughout the testicle. Sagittal US of the right testicle (below) again shows multiple punctate calcifications throughout the testicle. There is also an anechoic structure superior and inferior to the right testicle.