Hi, this is Tom, and in this episode I'm going to be going through Hydro Seals.

And you can find notes at 0.0.5.com and in the 0 to Finals Pediatrics book.

And you can find flashcards and questions at members.0.0.0.com.

So let's jump straight in.

A hydrocile is a collection of fluid within the tunica vaginalis, which is a sealed pouch of membrane

that surrounds the testes.

Originally, the tunica vaginalis is part of the peritoneal membrane.

During fetal development, it becomes separated from the peritoneal membrane, and it remains in

the scrotum partially covering each testicle. Let's talk about simple hydroceals. Simple hydroceals are common,

occurring in 5 to 10% of newborn males. They occur where fluid is trapped in the tunica

vaginalis, but the tunica vaginalist is separated from the peritoneal membrane.

Usually the fluid gets reabsorbed over time and the hydroceal disappears.

Let's talk about communicating hydroceals.

Communicating hydroceals occur where the tunica vaginalis around the testicle

remains connected to the peritoneal cavity via a pathway called the Processus Vaginalis.

Fluid can travel from the peritoneal cavity to the hydroceal, allowing the hydroceal to fluctuate in size.

Next let's talk about examination. Hydroceals cause a soft, smooth, non-tender swelling around one of the testes.

The hydroceal will transilluminate when holding a pentorch flat against the scrotum.

This means the entire lump will light up as the light fills the fluid inside the hydroceal.

Let's talk about the differential diagnosis.

The key differential diagnoses of a scrotal or an inguinal swelling in a neonate are a hydroceal,

which is common, undescended testes, which are common, inguinal hernias, which are common,

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