A hematocele is an accumulation of blood between the layers of the tunica vaginalis, the membrane surrounding the testicle. It most commonly results from scrotal trauma but can also occur after surgery or as a complication of testicular torsion. On ultrasound, a hematocele appears as fluid within the scrotal sac that is more echogenic than a simple hydrocele due to the blood content. Fresh blood may appear as echogenic fluid, while older blood may show septations, debris, or a fluid-debris level. Scrotal ultrasound is essential in evaluating traumatic hematoceles to assess whether the underlying testicle is intact or has suffered a rupture requiring surgical repair.
Sonography Term