? 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 of scrotal 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.
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- -No aggravating or relieving factors
- -No h/o sudden increase in size
- -No h/o pain
- -No h/o trauma
- -No h/o fever, chills & rigor
- -No h/o loss of appetite & weight
- -No h/o any other swelling
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PAST HISTORY :
- -No h/o TB, asthma, DM, hypertension, epilepsy, jaundice, STD
- -No h/o previous surgeries
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PERSONAL HISTORY:
- -normal bowel & bladder habits
- -consumes mixed diet
- -non smoker & non alcoholic
FAMILY HISTORY : not relevant
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GENERAL EXAMINATION
conscious, oriented, well built & nourished No pallor, icterus, cyanosis, clubbing, pedal edema, generalised lymphadenopathy
VITALS:
Pulse-72/min
RR-16/min
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BP-130/80mmhg
Temp-afebrile
LOCAL EXAMINATION
? Consent, exposed, posture
INSPECTION
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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
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Lying down – not reduced
EXAMINATION OF
- - Penis: midline, no deviation
- - Regional lymph nodes: no visible nodes
LEFT SIDE OF SCROTUM : Appears to be normal
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PALPATION
- Not warmth & not tender
- Inspectory findings - confirmed
? Surface - smooth
Consistency - tense & cystic
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GET ABOVE THE SWELLING– able to do
NOT REDUCIBLE
FLUCTUATION : + ve
TRANSILLUMINATION: -ve
NO COUGH IMPULSE
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Skin over the swelling : normal rugosity, not stretched
Examination of
TESTIS : not palpable, testicular sensation not done
? PENIS: normal
? URETHRAL MEATUS : normal, no strictures
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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
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Management :
Investigation:
Blood – cbc, tc, dc, esr, hb %, blood grouping
serum -sugar, urea, creatinine
urine – sugar, protein, deposits
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- - ECG & X-ray
- Mantoux & VDRL
USG of scrotum
TREATMENT:
EVERSION OF SAC – Rt side
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HYDROCELE
| PRIMARY | SECONDARY |
|---|---|
| Huge swelling | Small swelling (except- filarial) |
| Testis - not palpable | Testis – palpable |
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