CASE -1 AL- JAHRA HOSPITAL

Talal AlanziYr 330-1-2014

• Age :- 65 years• Sex :- Male• Continuous dull aching pain and • Progressive swelling right scrotum x >3 years

PRESENTING COMPLIANTS :-

• No h/o trauma• No h/o LUTS• No Chronic medical illness

• P.M.H +P.S.H normal• No drug allergy• Married with 3 children• Retired • Non smoker

O/E

• Both Testes and Epididymis Normal• Soft compressible non-tender swelling in the

rt.scrotum• Completely disappears while lying supine• Fluctuant but not transilluminant• No mass or Bruit in the abdomen• Sys.Ex. :- WNL

INVESTIGATIONS DONE :-

• USG /Doppler Scrotum /Rt.Groin:-

CT ANGIOGRAM ( VENOUS PHASE)

CONT…….

ConclusionIn this patient with misleading clinical signs, diagnosis was established radiologically. Had surgery proceeded without this investigation, significant intra-operative bleeding would have been likely.

Isolated right-sided varicocele as a salvage pathway for portal hypertension•G-M. Pinggera*,1 R. Herwig,  L. Pallwein,  F. Frauscher,  W. Judmaier,M. Mitterberger,  G. Bartsch,  A. Mallouhi 2Article first published online: 11 APR 2005DOI: 10.1111/j.1742-1241.2005.00530.Issue

International Journal of Clinical PracticeVolume 59, Issue 6, pages 740–742, June 2005

Surgery is inadvisable: Massive varicocele due to portal hypertensionHEINRICH SCHULTE-BAUKLOH*, JÖRG KÄMMER, RAINER FELFE, BURKARD STÜRZEBECHER, HELMUT H KNISPELArticle first published online: 30 SEP 2005DOI: 10.1111/j.1442-2042.2005.01170.xIssue

International Journal of UrologyVolume 12, Issue 9, pages 852–854, September 2005

ConclusionAttempted hydrocoele repair in this patient would have resulted in marked unanticipated blood loss and sudden ligation of the scrotal varicocoele may have precipitated rupture of other portal-systemic

bypasses. We consequently advocate cautious assessment of possible hydrocoele in patients with portal hypertension.

J Med Case Reports. 2008; 2: 363.Published online 2008 December 4. doi:  10.1186/1752-1947-2-363PMCID: PMC2612684A varicocoele mimicking a hydrocoele in a man with portal hypertension: a case reportGeorge Yardy,1 Akkib Rafique,2 Iain Sellers,3 Lawrence Berman,3 and Nigel Bullock1

Author information ► Article notes ► Copyright and License information ►

Case Reports in SurgeryVolume 2013 (2013), Article ID 709835, 3 pages

http://dx.doi.org/10.1155/2013/709835Case ReportUnilateral Giant Varicocele Mimicking Inguinal Hernia Resulting from Portosystemic Shunt without Evidence of Portal Hypertension: An Unusual Case ReportMuhammed Zahir, Hassan R. Al Muttairi, Surjya Prasad Upadhyay, andPiyush N. MallickAl Jahra Hospital, Ministry of Health, State of Kuwait, P.O. Box 40206, 01753 Safat, KuwaitReceived 5 January 2013; Accepted 5 February 2013Academic Editors: A. Cho, A. K. Karam, Y. Rino, and G. SandblomCopyright © 2013 Muhammed Zahir et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

DISCUSSION

• Isolated Asymptomatic Giant right sided varicocele in an elderly man -

• Whether to treat or not