Download MBBS Final Year Surgery Case Presentation Hydrocele Clinical Examination Discussion and Treatment

Download MBBS (Bachelor of Medicine and Bachelor of Surgery) Surgery Final Year Case Presentation Hydrocele Clinical Examination Discussion and Treatment

50 yrs old male patient Shankar coming from
Thousand lights , daily worker occupation ,
belonging to socio-economic status 4
presented with chief complaints of
SWELLING IN THE RIGHT SIDE OF SCROTUM
FOR 6 MONTHS

---

HISTORY OF PRESENTING ILLNESS
Patient was apparently normal 6 months back
after which he noticed a swelling in the right side ofscrotal
for the past 6 months which was
insidious in onset
initially small in size & gradually increased in size to
attain the current size and the swelling is
confined to the scrotal region.
-No aggravating or relieving factors
-No h/o sudden increase in size
-No h/o pain
-No h/o trauma
-No h/o fever, chil s & rigor
-No h/o loss of appetite & weight
-No h/o any other swelling

---

PAST HISTORY :
-No h/o TB , asthma , DM , hypertension ,
epilepsy , jaundice ,STD
-No h/o previous surgeries
PERSONAL HISTORY:
-normal bowel & bladder habits
-consumes mixed diet
-non smoker & non alcoholic
FAMILY HISTORY : not relevant

---

GENERAL EXAMINATION
conscious, oriented ,well built &nourished
No pallor ,icterus , cyanosis , clubbing, pedal
edema , generalised lymphadenopathy
VITALS:
Pulse-72/min
RR-16/min
BP-130/80mmhg
Temp-afebrile

---

LOCAL EXAMINATION
Consent , exposed , posture
INSPECTION
SINGLE swelling of size-7*5cm present in the RT
side of SCROTUM , OVOID in shape extending from
the root to base of scrotum
- Surface : smooth
- skin over the swelling ? not stretched , rugosity
is seen
- no scars , sinuses , dilated veins , visible
pulsation ,
- no visible cough impulse
Lying down ? not reduced

---

EXAMINATION OF
- Penis : midline , no deviation
-Regional lymph nodes: no visible nodes
LEFT SIDE OF SCROTUM : Appears to be normal

---

PALPATION
Not warmth & not tender
Inspectory findings ? confirmed
Surface - smooth
Consistency ? tense & cystic
GET ABOVE THE SWELLING? able to do
NOT REDUCIBLE
FLUCTUATION : + ve
TRANSILLUMINATION : -ve
NO COUGH IMPULSE
Skin over the swelling : normal rugosity , not
stretched

---

Examination of
TESTIS : not palpable , testicular sensation not
done
PENIS: normal
URETHRAL MEATUS : normal , no strictures
REGIONAL LYMPH NODES: not palpable
LEFT SIDE OF SCROTUM : normal
PR : to be done

---

Diagnosis:
Primary vaginal hydrocele of right side of scrotum
without any complications
Management :
Investigation:
Blood ? cbc , tc , dc, esr , hb % , blood grouping
serum ?sugar , urea , creatinine
urine ? sugar , protein , deposits
ECG & X-ray
Mantoux & VDRL
USG of scrotum
TREATMENT:
EVERSION OF SAC ? Rt side

---

HYDROCELE
PRIMARY
SECONDARY
Huge swel ing
Small swel ing
(except- filarial)
Testis - not palpable
Testis - palpable

---