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Scrotal Swelling, D/D Hernia
Discussion in 'All Categories' started by Saravanan. J - Jun 12th, 2012 10:18 am.
Saravanan. J
Saravanan. J
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.
re: Scrotal Swelling, D/D Hernia by Dr J S Chowhan - Jun 13th, 2012 6:44 am
Dr J S Chowhan
Dr J S Chowhan
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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