| Discussion in 'All Categories' started by Saravanan. J - Jun 12th, 2012 10:18 am. | |
Saravanan. J
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Right Inguino Scrotal Swelling, D/D Hernia ( Evidence of echogenic lesion with peristalsis seen in the right liguino scrotal with cough impulse noted) in the Ultrasound study. |
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re: Scrotal Swelling, D/D Hernia
by Dr J S Chowhan -
Jun 13th, 2012
6:44 am
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Dr J S Chowhan
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Dear Saravanan According to the USG report and your clinical symptoms it looks like you have inguinal hernia. The differential diagnosis possible is: a) Hydrocele b) Saphena varix c) Femoral hernia d) Varicocele e) Direct inguinal hernia Although a huge list is also there. D.D of Inguinal swellings ? 1- cystic : I- Hernias: 1- Inguinal (direct or indirect) diagnosed by Int. ring test & Zieman's test. 2- Femoral hernia * below & lat. to the pubic tubercle. * Zieman's test impulse perceived by ring finger II- Artery Iliofemoral aneurysm (compressible , pulsating swelling along the line of artery , moves across artery not along it) III- Vein Saphena varix (compressible swelling at saphenous opening show thrill on cough & evidence of V.V. of the lower limb.) IV- lymphatic cyst V – Muscle a) Psoas abscess 1-Evidence of disease of the spine (Pott's disease of spine) 2-Dull on percussion 3-Slightly compressible 4-It appears as cross fluctuant swelling across the inguinal ligament b) Psoas bursitis 1- tense ,cystic swelling beneath inguinal ligaments 2- disappear on flexion of the hip 3- evidence of hip osteoarthritis VI- Skin & SC tissues: e.g. * sebaceous cyst * lipoma (soft swelling with pseudo-fluctuation) 2- solid : I- Lymph node Inguinal lymphadenitis : a- Tender & multiple swellings b- inguinal canal is empty. II- Testicle Undescended or ectopic testicle a- swelling has characteristic testicular sensation b- scrotum is empty Please consult any good physician for confirmation. With regards J.S. Chowhan |
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