TY - JOUR T1 - IMage of the month—quiz case AU - Jindal T, Sharma N Y1 - 2011/06/01 N1 - 10.1001/archsurg.2011.137-a JO - Archives of Surgery SP - 757 EP - 757 VL - 146 IS - 6 N2 - A 24-year-old man presented with complaints of a gradually progressive, right lower abdominal swelling and right scrotal enlargement for 2 years. There was no history of pain or sudden increase or decrease in the size of the swelling or urinary disturbances. There was no history of trauma. Physical examination revealed a smooth, fluctuant, right abdominal swelling extending from the level of the umbilicus up to the inguinal ligament (Figure 1). There was a smooth, cystic swelling causing marked enlargement of the right half of the scrotum. There was no local increase in temperature and no tenderness. The left testis was within the scrotum, but the right testis was not palpable. When the patient was asked to cough, the examiner felt a palpable thrill. The abdominal and scrotal swellings, when palpated simultaneously, showed cross-fluctuation. Both the swellings were transilluminant. SN - 0004-0010 M3 - doi: 10.1001/archsurg.2011.137-a UR - http://dx.doi.org/10.1001/archsurg.2011.137-a ER -