GEMATOTSELE (haematocele; Greek haima, haimat[os] blood + kele tumor; synonym blood tumor) — accumulation of blood between parietal and visceral plates of a vulval cover of a small egg (an intravaginalny form) or in fabrics of a scrotum (an ekstravaginalny form). This term designate also accumulation of blood in limited space, napr, between leaves of a wide ligament of uterus, in duglasovy space.
G. arises owing to an injury of a scrotum, after a puncture of a blood vessel at a puncture of a vulval cover of a small egg (e.g., for removal of liquid at the gidrotsel), or at a biopsy of a small egg at hron, the hemorrhagic inflammation of a vulval cover of a small egg which is followed by hemorrhage in a cavity of a cover and education on its inner surface of granulyatsionny fabric with richly developed network of capillaries.
Pathoanatomical changes are various depending on G. Vnachale's prescription find the turned blood, later — brown old blood and kashitseobrazny weight. Further there is an organization of clots to considerable growth of connecting fabric, sometimes to education in it limy, cartilaginous or bone plaques; owing to a prelum and disturbance of blood circulation of a small egg there can come its atrophy.
The clinical picture
At an intravaginalny form after an injury is quickly formed not translucent — unlike the gidro-tsel — painful «tumor»; its size can be so considerable that the small egg is not probed. At an ekstravaginalny form, except «tumor», the hemorrhage in skin of a scrotum sometimes extending to a hip and inguinal area is observed. From complications G.'s infection
== the Differential diagnosis == is more often observed It is necessary to distinguish G. from to a gidrotsela (see), inflammatory processes scrotums (see), inguinal hernia (see. Hernias ), new growths and an inflammation of a small egg and its appendage (see. Small egg ).
Right after developing of hemorrhage is recommended by rest, cold for a scrotum. G.'s puncture is usually ineffective since bleeding often renews. Besides, after a puncture the hematoma quite often suppurates. Surgical intervention is shown in the absence of effect of conservative treatment, at G.'s suppuration, extensive development of calcification and consolidation of a cover (for the prevention of a secondary atrophy of a small egg).
The forecast at it is timely carried out to lay down. actions it is favorable.
Bibliography: The guide to clinical urology, under the editorship of A. Ya. Pytel, page 482, M., 1970, bibliogr.; Klinische UrOlogie * hrsg. v. G. E. Alken u. W. Staehler, S. 484, Stuttgart, 1973.
A. A. Buchmann