Ultrasound evidence of a funicular cord hydrocele in a six-week infant

Scrotal hydrocele is, in infants and children, a frequent benign condition. Decidedly rarer are the forms of hydrocele where there is not residual communication with tunica vaginalis. A 6-week-old infant presented with painless acute onset of inguinal swelling covered by erythematous skin. The scrotal ultrasound showed a 26x21x10 mm lobulated-saccate fluid collection in the context of the right spermatic funiculus, communicating with peritoneal cavity, compatible with cord hydrocele in its funicular variant. Hydrocele of the spermatic cord results from failure to close the vaginal process. Objective examination and ultrasonography can provide differential diagnosis from other conditions that can cause inguinal-scrotal swelling such as inguinal hernia, varicocele, testicular torsion, epididymis cyst, and spermatocele. Treatment options range from conservative measures to surgery, mostly depending on clinical evolution and subtypes.