Hydrocele is an accumulation of fluid between the testis and its vaginal coat. It may be very abundant. It commonly affects people who live in tropical regions. We report the case of a 56-year old patient, Mr. YM, living in the sahelian zone with very abundant hydrocele and thickening of vaginal coat associated with bag ulcer. The patient presented with big bag associated with a feeling of heaviness as well as annoyance when walking, evolving for about one year with progressive increase in volume. Clinical examination showed voluminous left bag (A,B) with a plague measuring 3 cm (A). Two diagnosis were suspected: voluminous hydrocele (more probable) and severe scrotal tumor. Ultrasound of the bag showed very abundant effusion of in the vaginal coat (3000 ml) with thickening of the tunica vaginalis measuring 7 mm in diameter. The diagnosis of very abundant unilateral hydrocele associated with pachyvaginalitis was retained. The extractions of 2.8 L of stained fluid was performed during surgery (C). Postoperative course was favorable (D) under triple antibiotic therapy.
Keywords: Hydrocele; scrotum; ulceration; ultrasound; unilateral.