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Surgery.(General 1).Scrotum > 8. Hydrocele > Flashcards

8. Hydrocele Flashcards

1
Q

Hydrocele

A
  1. Definition

2. CLASSIFICATION

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2
Q

Definition of Hydrocele

A

Collection of clear serous Fluid inside a part of the processus vaginalis

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3
Q

CLASSIFICATION of Hydrocele

A
  1. Hydrocele of the spermatic cord

2. Hydrocele of the tunica vaginalis

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4
Q

Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

a. Encysted hydrocele of the cord

b. Hydrocele of the hernial sac

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5
Q

Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A
  1. ETIOLOGY
  2. CLINICAL PICTURE
  3. Differential Diagnosis
  4. TREATMENT
  5. Note
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6
Q

ETIOLOGY of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

Due to persistence of the intermediate part of the processus vaginalis

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7
Q

CLINICAL PICTURE of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A
  1. Age of presentation
  2. Symptoms
  3. Examination
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8
Q

Age of presentation in CLINICAL PICTURE of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

It usually appears in childhood although it’s congenital

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9
Q

The reason why It usually appears in childhood although it’s congenital in Age of presentation in CLINICAL PICTURE of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

because fluid takes time to accumulate.

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10
Q

Symptoms in CLINICAL PICTURE of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

Painless swelling in the scrotal part of the spermatic cord.

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11
Q

Examination in CLINICAL PICTURE of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

Swelling with the following characters :

  1. Site
  2. Size
  3. Shape
  4. Edge
  5. Surface
  6. Consistency
  7. Special character
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12
Q

Site of the swelling in Examination in CLINICAL PICTURE of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

Scrotal part of the spermatic cord.

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13
Q

Size of the swelling in Examination in CLINICAL PICTURE of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

Small.

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14
Q

Shape of the swelling in Examination in CLINICAL PICTURE of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A
  1. Oval in shape

2. Its long axis is along the axis of the cord

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15
Q

Edge of the swelling in Examination in CLINICAL PICTURE of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

Well defined

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16
Q

Surface of the swelling in Examination in CLINICAL PICTURE of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

Smooth.

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17
Q

Consistency of the swelling in Examination in CLINICAL PICTURE of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

Tense cystic

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18
Q

Special character of the swelling in Examination in CLINICAL PICTURE of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A
  1. Mobility

2. Translucency

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19
Q

Mobility in Special character of the swelling in Examination in CLINICAL PICTURE of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A
  1. It can be moved from side to side but not from above downwards.
  2. With gentle traction on the testis, it is pulled downwards and becomes fixed
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20
Q

Translucency in Special character of the swelling in Examination in CLINICAL PICTURE of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

Translucent

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21
Q

Differential Diagnosis of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

Epididymal cysts & spermatocele.

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22
Q

The main difference from epididymal cysts & spermatocele in Differential Diagnosis of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

There is GAP between it & the testis in Epididymal cysts & spermatocele

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23
Q

TREATMENT of Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

Excision through an inguinal incision

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24
Q

Note about Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

Hydrocele of the canal of Nuck is similar to encysted hydrocele of the cord

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25
Q

Hydrocele of the canal of Nuck in Note about Encysted hydrocele of the cord in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A
  1. Occurs in females

2. The cyst lies in relation to the round ligament of the uterus.

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26
Q

Hydrocele of the hernial sac in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A
  1. Incidence
  2. Predisposing factor
  3. ETIOLOGY
  4. CLINICAL PICTURE
  5. TREATMENT
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27
Q

Incidence of Hydrocele of the hernial sac in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

It’s a rare complication of Hernia

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28
Q

Predisposing factor of Hydrocele of the hernial sac in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

Use of Truss

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29
Q

ETIOLOGY of Hydrocele of the hernial sac in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

Due to fluid accumulation in an empty hernial sac which has been shut off from the peritoneal cavity by omentum or by adhesions

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30
Q

CLINICAL PICTURE of Hydrocele of the hernial sac in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A
  1. Symptoms

2. Examination

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31
Q

Symptoms of CLINICAL PICTURE of Hydrocele of the hernial sac in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A
  1. There is history of a hernia.

2. Later, there is an irreducible pyriform swelling in the upper part of the cord.

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32
Q

Examination of CLINICAL PICTURE of Hydrocele of the hernial sac in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

Swelling with the following characters

  1. Consistency
  2. Special characters
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33
Q

Consistency of the swelling in Examination of CLINICAL PICTURE of Hydrocele of the hernial sac in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

The swelling is cystic

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34
Q

Special characters of the swelling in Examination of CLINICAL PICTURE of Hydrocele of the hernial sac in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A
  1. Translucency

2. Mobility

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35
Q

Translucency of the swelling in Special characters of the swelling in Examination of CLINICAL PICTURE of Hydrocele of the hernial sac in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

The swelling is translucent

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36
Q

Mobility of the swelling in Special characters of the swelling in Examination of CLINICAL PICTURE of Hydrocele of the hernial sac in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A
  1. The swelling is mobile from side to side but not from above downwards.
  2. Gentle traction on the testis does not alter the mobility of the swelling.
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37
Q

TREATMENT of Hydrocele of the hernial sac in Hydrocele of the spermatic cord in CLASSIFICATION of Hydrocele

A

Like that of the hernia

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38
Q

Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

a. Congenital Hydrocele
b. Infantile Hydrocele
c. Vaginal Hydrocele

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39
Q

Congenital Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. ETIOLOGY
  2. Clinical picture
  3. Differential Diagnosis
  4. Treatment
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40
Q

ETIOLOGY of Congenital Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Due to persistence of the whole processus vaginalis.

2. The communication with the peritoneal cavity is too small to permit the development of a hernia.

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41
Q

Clinical picture of Congenital Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Symptoms

2. Examination

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42
Q

Symptoms in Clinical picture of Congenital Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

The mother complains that her infant has a scrotal swelling

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43
Q

Criteria of the scrotal swelling in Symptoms in Clinical picture of Congenital Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Minimal in the morning

2. Reaches maximum size by the end of the day

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44
Q

Examination in Clinical picture of Congenital Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Local Examination

2. Abdominal examination is essential (old info)

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45
Q

Local Examination in Examination in Clinical picture of Congenital Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Inguinoscrotal cystic translucent swelling.
  2. The hydrocele fills gradually on standing and empties very slowly (irreducible) if the patient lies down and the scrotum is elevated
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46
Q

The reason why Abdominal examination is essential in Examination in Clinical picture of Congenital Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

because in some cases it may be 1ry manifestation of T.B. peritonitis

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47
Q

Differential Diagnosis of Congenital Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Congenital Hernia

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48
Q

The main difference between Congenital Hydrocele and Congenital Hernia in Differential Diagnosis of Congenital Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

The congenital hernia

  1. It’s easily reducible
  2. Gives expansile impulse on crying.
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49
Q

TREATMENT of Congenital Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Surgery through an inguinal incision

2. Dividing of the sac into two parts

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50
Q

Dividing of the sac into two parts in TREATMENT of Congenital Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Management of

  1. The upper part of the sac
  2. The lower part of the sac
51
Q

Management of The upper part of the sac in Dividing of the sac into two parts in TREATMENT of Congenital Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Transfixion & excision of the upper part at the level of the internal ring as a hernia

52
Q

Management of The lower part of the sac in Dividing of the sac into two parts in TREATMENT of Congenital Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Eversion of the lower part as in hydrocele.

53
Q

Infantile Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. ETIOLOGY
  2. Clinical picture
  3. Treatment
54
Q

ETIOLOGY of Infantile Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Due to obliteration of the processus vaginalis only at the level of the internal ring
  2. The tunica does not communicate with the
    peritoneal cavity
55
Q

Clinical picture of Infantile Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. As congenital hydrocele but with no diurnal variation in size
  2. Sometimes the differentiation is known only at operation
56
Q

Treatment of Infantile Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Excision of the upper part & eversion of the lower part.

57
Q

Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Definition

2. Etiology

58
Q

Definition of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Fluid collection in the tunica vaginalis

59
Q

Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Primary hydrocele

2. Secondary hydrocele

60
Q

Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. ETIOLOGY
  2. PATHOLOGY
  3. CLINICAL PICTURE
  4. COMPLICATIONS
  5. Investigations
  6. TREATMENT
61
Q

ETIOLOGY of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. The cause of this condition is not known

2. Theories

62
Q

Theories in ETIOLOGY of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Obstruction of the lymphatics draining the testis due to repeated attacks of subclinical epididymo-orchitis (most accepted theory).
  2. Chronic congestion and irritation by repeated trauma
63
Q

Most accepted theory in Theories in ETIOLOGY of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Obstruction of the lymphatics draining the testis due to repeated attacks of subclinical epididymo-orchitis

64
Q

PATHOLOGY of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. It may be unilateral or bilateral.
  2. There is accumulation of fluid in the tunica vaginalis, which may reach an enormous size.
  3. The hydrocele fluid
  4. The tunica vaginalis
65
Q

The hydrocele fluid in PATHOLOGY of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Color
  2. Composition
  3. Specific gravity
66
Q

Color of The hydrocele fluid in PATHOLOGY of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Amber yellow

67
Q

Composition of The hydrocele fluid in PATHOLOGY of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

It’s a thin fluid and contains

  1. Water
  2. Inorganic salts
  3. Fibrinogen
  4. Albumin
  5. Cholesterol crystals in old standing cases
68
Q

Concentration of albumin in Composition of The hydrocele fluid in PATHOLOGY of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

A. 6 gm%

B. Resembles an exudate.

69
Q

Specific gravity of The hydrocele fluid in PATHOLOGY of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

1020-1024.

70
Q

The tunica vaginalis in PATHOLOGY of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

becomes thickened and fibrosed in old standing cases

71
Q

CLINICAL PICTURE of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Age of presentation
  2. Symptoms
  3. Examination
72
Q

Age of presentation in CLINICAL PICTURE of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Middle aged males

2. Elderly males

73
Q

Symptoms in CLINICAL PICTURE of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Painless swelling of the scrotum.

74
Q

Examination in CLINICAL PICTURE of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

A. Swelling with the following characters ;

  1. Site
  2. Size
  3. Shape
  4. Edge
  5. Surface
  6. Consistency
  7. Special character

B. Note

75
Q

Site of the swelling in Examination in CLINICAL PICTURE of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Purely scrotal swelling by Scrotal neck test

76
Q

Size of the swelling in Examination in CLINICAL PICTURE of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Moderate to huge

77
Q

Shape of the swelling in Examination in CLINICAL PICTURE of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Pyriform

78
Q

Edge of the swelling in Examination in CLINICAL PICTURE of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Well defined

79
Q

Surface of the swelling in Examination in CLINICAL PICTURE of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Smooth

80
Q

Consistency of the swelling in Examination in CLINICAL PICTURE of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Cystic with bipolar fluctuation test

2. Dull on percussion

81
Q

Special character of the swelling in Examination in CLINICAL PICTURE of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. There is no impulse on cough

2. Translucent on transillumination

82
Q

Note about Examination in CLINICAL PICTURE of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

The hydrocele fluid surrounds the testis, which is often impalpable

83
Q

COMPLICATIONS of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Infection
  2. Hemorrhage
  3. Rupture
  4. Calcification.
  5. Hydrocele en bisac
  6. Huge expansion of the scrotum
84
Q

Infection in COMPLICATIONS of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Leading to pyocele

2. usually after aspiration.

85
Q

Hemorrhage in COMPLICATIONS of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Leading to haematocele

2. Either after trauma, or spontaneously.

86
Q

Rupture in COMPLICATIONS of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

usually follows trauma.

87
Q

Hydrocele en bisac in COMPLICATIONS of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Definition

2. Morphology

88
Q

Definition of Hydrocele en bisac in COMPLICATIONS of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Herniation of the hydrocele sac through the dartos muscle

89
Q

Morphology of Hydrocele en bisac in COMPLICATIONS of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Two sacs one small one large

90
Q

Huge expansion of the scrotum in COMPLICATIONS of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Leading to indrawing of the penis

2. May interfere with micturition and intercourse.

91
Q

Investigation of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Scrotal U.S.

92
Q

Scrotal U.S. in Investigation of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Significance

2. Advantages

93
Q

Significance of Scrotal U.S. in Investigation of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Diagnostic

94
Q

Advantages of Scrotal U.S. in Investigation of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Identifies the testis that is difficult to palpate.
  2. Identifies character of fluid in this hydrocele
  3. Excludes eversion of testis
  4. Excludes testicular tumours as vaginal hydrocele is a rare presentation of testicular tumour
95
Q

TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Aspiration is better avoided

2. Surgical Treatment

96
Q

The reason why Aspiration is better avoided in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Recurrence is inevitable.
  2. May be complicated by infection or hemorrhage.
  3. There may be an underlying testicular tumour.
97
Q

Surgical Treatment in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Eversion of the tunica vaginalis
  2. Subtotal excision of the tunica vaginalis
  3. Plication of tunica vaginalis
98
Q

Eversion of the tunica vaginalis in Surgical Treatment in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Alternative name
  2. Operative details
  3. Disadvantage
  4. Overcoming the disadvantage
99
Q

Alternative name for Eversion of the tunica vaginalis in Surgical Treatment in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Jaboulay’s operation

100
Q

Operative details in Eversion of the tunica vaginalis in Surgical Treatment in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Incision

2. Steps

101
Q

Incision in Operative details in Eversion of the tunica vaginalis in Surgical Treatment in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

A small transverse incision is done in the skin of the scrotum.

102
Q

Steps in Operative details in Eversion of the tunica vaginalis in Surgical Treatment in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. The hydrocele sac is delivered, opened & the hydrocele fluid is evacuated.
  2. The tunica is everted & stitched behind the epididymis.
103
Q

The reason why The tunica is everted & stitched behind the epididymis in Steps in Operative details in Eversion of the tunica vaginalis in Surgical Treatment in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

so that any fluid formed will be drained by the lymphatics of the scrotum.

104
Q

Disadvantage of Eversion of the tunica vaginalis in Surgical Treatment in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Sometimes recurrence occurs forming Tyre hydrocele

2. Eftekasa only in ASU

105
Q

Overcoming the disadvantage of Eversion of the tunica vaginalis in Surgical Treatment in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Under-running sutures are taken in the free edge of the tunica

106
Q

Subtotal excision of the tunica vaginalis in Surgical Treatment in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Meaning of subtotal

2. Indications

107
Q

Meaning of subtotal in Subtotal excision of the tunica vaginalis in Surgical Treatment in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Removal of all tunica except the visceral layer

108
Q

Indications of Subtotal excision of the tunica vaginalis in Surgical Treatment in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. a large hydrocele

2. Thick walled or calcified tunica vaginalis

109
Q

Plication of tunica vaginalis in Surgical Treatment in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Alternative name
  2. Principle
  3. Indications
  4. Advantages
110
Q

Alternative name for Plication of tunica vaginalis in Surgical Treatment in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Lord’s operation

111
Q

Principle of Plication of tunica vaginalis in Surgical Treatment in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

A series of 10-12 absorbable sutures “chromic catgut” are woven radially from the free edge of the tunica to the reflection of the tunica from the testis & epididymis.

112
Q

Indications of Plication of tunica vaginalis in Surgical Treatment in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Suitable only for cases where the tunica is not thickened “thin tunica”

113
Q

Advantages of Plication of tunica vaginalis in Surgical Treatment in TREATMENT of Primary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Less incidence of bleeding & scrotal haematoma.

2. No Recurrence.

114
Q

Secondary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Etiology
  2. Examination
  3. Treatment
  4. Note
115
Q

Etiology of Secondary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

a) Acute hydrocele

b) Chronic hydrocele

116
Q

Etiology of Acute hydrocele in Etiology of Secondary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Acute epididymo-orchitis

or

  1. Testicular tumour.
117
Q

Etiology of Chronic hydrocele in Etiology of Secondary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. Testis Pathology
  2. Epididymis Pathology
  3. Spermatic cord Pathology
  4. Post-operative Etiology
118
Q

Testis Pathology in Etiology of Chronic hydrocele in Etiology of Secondary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Malignant tumours

119
Q

Epididymis Pathology in Etiology of Chronic hydrocele in Etiology of Secondary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. T.B
  2. bilharziasis
  3. Filariasis.
120
Q

Spermatic cord Pathology in Etiology of Chronic hydrocele in Etiology of Secondary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Varicocele

121
Q

Post-operative Etiology in Etiology of Chronic hydrocele in Etiology of Secondary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. After herniorrhaphy if external ring is made tight

2. After inguinal varicocelectomy.

122
Q

Examination of Secondary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A
  1. 2ry hydrocele is small and lax

2. Detected by pinch test

123
Q

Treatment of Secondary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Treatment of the cause

124
Q

Note about Secondary hydrocele in Etiology of Vaginal Hydrocele in Hydrocele of the tunica vaginalis in CLASSIFICATION of Hydrocele

A

Beware of acute hydrocele in a young man, there may be an underlying testicular neoplasm

Surgery.(General 1).Scrotum (8 decks)

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