Tension Hydrocele-How Point-of-care Ultrasound Helps in the Emergency Department: A Case Report

Division

Far West

Hospital

Riverside Community Hospital

Document Type

Case Report

Publication Date

8-1-2026

Keywords

POCUS, point-of-care ultrasound, tension hydrocele

Disciplines

Diagnosis | Emergency Medicine | Male Urogenital Diseases

Abstract

INTRODUCTION: Tension hydrocele is a rare but serious complication that can threaten testicular viability. This case report describes how testicular point-of-care ultrasound (POCUS) enabled timely recognition of a large hydrocele compromising testicular perfusion and guided management.

CASE REPORT: A 57-year-old male presented to the emergency department (ED) with painful right scrotal swelling. Testicular POCUS demonstrated a large hydrocele with reduced intratesticular blood flow. A scrotal centesis performed by the emergency physician led to symptom resolution and restoration of normal flow.

CONCLUSION: Testicular POCUS can rapidly identify impaired perfusion and guide scrotal centesis in the ED, a temporary yet potentially testis-saving intervention.

Publisher or Conference

Clinical Practice and Cases in Emergency Medicine

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