D.D. of Scrotal & Inguino-scrotal Swellings

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Presentation transcript:

D.D. of Scrotal & Inguino-scrotal Swellings ALI SABBOUR Prof. of General & Vascular Surgery, Ain Shams University

1- Can you get above the swelling? FIRST, Decide the answer of these four questions: 1- Can you get above the swelling? 2- Can you identify the testes & the epididymis? 3- Is the swelling translucent? 4- Is the swelling tender?

Swellings NOT Confined to the Scrotum: Cough Impulse Reducible Testis palpable Opaque No cough impulse Not reducible Testis not palpable CYSTIC TRANSLUCENT HERNIA INFANTILE HYDROCELE

Swellings NOT Confined to the Scrotum: Cough Impulse Reducible Testis palpable Opaque

Swellings NOT Confined to the Scrotum: No cough impulse Not reducible Testis not palpable CYSTIC TRANSLUCENT

Swellings Confined to the Scrotum: Testis & Epididymis NOT Definable Translucent Opaque Not Tender Tender Ch. Hematocele Torsion Acute Hematocele Severe epid.orchitis Vaginal Hydrocele Gamma / Tumour

Swellings Confined to the Scrotum: Testis & Epididymis NOT Definable Translucent

Swellings Confined to the Scrotum: Testis & Epididymis NOT Definable Opaque Not Tender

Swellings Confined to the Scrotum: Testis & Epididymis NOT Definable Opaque Tender

Swellings Confined to the Scrotum: Testis & Epididymis DEFINABLE Translucent Opaque TENDER NOT TENDER Epididymal Cyst Acute Epididymo-orchitis TB Epididymis Tumour (early) Hydrocele of Cord Cystic & Opaque (Spermatocele)

Swellings Confined to the Scrotum: Testis & Epididymis DEFINABLE Translucent Cystic

Swellings Confined to the Scrotum: Testis & Epididymis DEFINABLE Opaque TENDER

Swellings Confined to the Scrotum: Testis & Epididymis DEFINABLE Opaque NOT TENDER

VARICOCELE Inguino- scrotal Swelling Bunch of dilated tortuous veins in the pampiniform plexus (Varicose veins in the spermatic cord) More on the left side Veins empty when the patient is lying down VARICOCELE

Scrotal Swelling Can’t feel testis & epididymis Cystic, translucent Not tender Vaginal Hydrocele

Acute Lt. inguinal lymphadenitis Lt. strangulated inguinal hernia Strangulated Lt. inguinal hernia Rt. congenital inguinal hernia