Scrotal swelling
Introduction
Introduction Scrotal enlargement refers to the lesion of the scrotal skin and its contents (sheath, testis, epididymis and spermatic cord), or the contents of the abdominal cavity (ascites, internal organs) and the like fall into the scrotum, resulting in an increase in the size of the scrotum. The scrotum wall or sheath, testis, epididymis and spermatic cord and other scrotum contents, due to acute and chronic inflammation, parasitic invasion, its own organic changes, tumors, etc. can cause pathological swelling of the scrotum, or inflammatory exudation Increase, edema and effusion. If the peritoneal sheath is not closed or not fully closed after birth, the contents of the abdominal cavity can reach the scrotum. Clinically, medical history and local palpation, light transmission tests and other physical examinations can determine the location and nature of the scrotal enlargement and make a correct diagnosis.
Cause
Cause
According to the lesions that cause swelling of the scrotum, it can be divided into three categories:
(1) scrotal wall lesions:
Such as clear wall edema scrotal wall hematoma, scrotum wall cutaneous swelling after filariasis, erysipelas skin gangrene, cellulitis, urinary extravasation scrotal wall benign tumor, sebaceous tumor, hemangioma X scrotum wall malignant tumor.
(B) the lesions of the scrotum inclusions:
1. Sheath: hydrocele of the hydrocele, hydrocele, and hydrocele.
2. Epididymis: acute and chronic epididymitis, epididymal tuberculosis, epididymis blood worm sterilization after surgery, stasis, semen cyst.
3. Testicles: Testicular inflammation Testicular tuberculosis, testicular syphilis, testicular tumors.
4. spermatic cord: spermatic sphincter hydrocele, varicocele, spermatic cord to reverse the spermatic sheath cyst, spermatic cord blood nodule, spermatic cord hematoma sterilization after vas deferens nodules, sterilization After sperm granuloma.
(3) The contents of the abdominal cavity enter the scrotum:
Such as ascites or inguinal hernia content (small intestine bladder, omentum, etc.) into the scrotum.
Examine
an examination
Related inspection
Viscosity scrotal ultrasound examination semen examination prostatic fluid pathogen estrone (E1)
Physical examination:
1. Local palpation: Local palpation is the most important and simple method for diagnosing scrotal enlargement. The scrotum and its contents belong to the external genital organs. The examiner must be familiar with the general anatomy of the contents of the scrotum in order to clearly diagnose the lesion. The scrotum is also the skin of the scrotum, whether it is from the scrotal contents, or from the groin area, is the testicular swelling, or the epididymal enlargement, cystic enlargement or substantial enlargement. During the examination, the patient should first take the standing, followed by the lying position examination, and the examiner's hands palpation at the same time is beneficial to the left and right comparison.
2. Cough impact: For the masses from the abdominal muscle sulcus area, the cough impact is examined to identify the inguinal hernia and hydrocele.
3. Light transmission test: It is of great value for identifying whether the scrotal enlargement is cystic or substantial.
4. Scrotal puncture: In order to identify the nature of the scrotal effusion, puncture and drainage can be performed, but for the substantial enlargement, the tissue can be aspirated for pathological examination.
5. Other examinations: including abdominal examination of the prostate examination and related general examination.
Laboratory inspection:
Hematuria and erythrocyte sedimentation tests have certain diagnostic significance in acute and chronic infections. Blood smears have diagnostic value for the diagnosis of scrotal elephantiasis. Determination of blood or urine human chorionic gonadotropin (HCG) and a fetus Globulin (AFG) is important for the diagnosis of testicular choriocarcinoma or embryonal cancer.
Imaging diagnosis:
Mainly there are ultrasound examination Doppler ultrasonography, angiography, infrared scrotal temperature recording method (Scrotalthenngraphy) and other comprehensive diagnostic ideas.
Diagnosis
Differential diagnosis
Differential diagnosis:
It should be differentiated from the following symptoms:
1. Scrotal swelling: Scrotal enlargement refers to the scrotal skin and its contents (the sheath testis, epididymis and spermatic cord) have lesions, or the contents of the abdominal cavity (ascites viscera) fall into the human scrotum, resulting in an increase in the size of the scrotum.
2. Painless scrotum mass: In the courtyard of the scrotum, usually only the testicles, epididymis, spermatic cords are inhabited, but sometimes strange faces appear, one of which is seminal vesiculitis. It is more common in middle-aged people. Seminal vesiculitis is a cystic, painless or mild pain, sometimes accompanied by a scrotal mass with a sense of falling, containing sperm and fluid.
3. A painless mass that gradually enlarges in one side of the scrotum: Diagnosis of hydrocele is not difficult. A painless mass that gradually enlarges in one side of the scrotum, which is smooth, cystic, and positive in light transmission, can be diagnosed. However, if accompanied by inflammation, bleeding, etc., the light transmission test can be negative.
