Haematocele

HAEMATOCELE, haematocele (from Greek haima-blood and kele-tumor), accumulation of blood in the cavity of the tunica vaginalis propria of the testicle or in the scrotal tissues outside the tunica vaginalis. H. is almost always of traumatic origin and usually develops in cases of hydrocele as a result of a blow to the scrotum or puncture of the tunica vaginalis for the purpose of removing exudate. Most often in the etiology of H. there is a rupture of some vessel in the presence of hydrocele (see). There are intravaginal and extravaginal forms of H. Patho-anatomical changes are varied depending on the duration of H. In fresh cases-clotted blood; subsequently in the contents of the H. sac protein-fat detritus and cholesterol are found; in chronic cases-sclerosis of the sac walls with atrophy of the testicle. Clinical symptoms in the intravaginal form-rapid formation of a non-transilluminating (unlike hydrocele), painful tumor, in the presence of a traumatic factor. In the extravaginal form, such a tumor is accompanied by a bruise of the scrotal skin, and sometimes of the groin and thighs. In diagnosis, H. should be distinguished from hydrocele, inflammatory and neoplastic processes in the testicle, and from hernia. In prognosis, the possibility of infection or transition to a chronic form with subsequent atrophy of the testicle should be kept in mind. Treatment: In the early stages of H., rest, ice is recommended, subsequently-heat and procedures promoting resorption; in case of suppuration, pain and high temperature-wide incision and tamponade. Retroperitoneal hematoma (haematocele retrouterina), see Extrauterine pregnancy. Lit.-see lit. to art. Hydrocele.