{"schema":"https://ver.cy/schemas/card/1.0.0","id":"vr.tr.haematocele-of-tunica-vaginalis-testis","code":"thing-q1620444","url":"https://ver.cy/models/thing/q1620444/","name":"haematocele of tunica vaginalis testis","alternateNames":["hemoscrotum"],"kind":"thing","status":"published","version":"0.1.0-research.1","language":"en","classifiers":{"family":"Thing Registry","category":"Information and virtual systems","entryKind":"thing","plane":"INF","domain":["INF.KNW"],"industry":[],"navPath":"","tags":[],"facets":{}},"whatItIs":"A haematocele of the tunica vaginalis testis is an accumulation of blood within the potential space between the visceral and parietal layers of the tunica vaginalis surrounding the testis.","purpose":"Enable an agent to recognise a suspected or confirmed blood collection in the tunica vaginalis, track its course and support clinician decisions about further assessment and management.","scope":{"in":["Anatomical localisation and laterality of the tunica vaginalis blood collection","Evidence supporting haemorrhagic contents and competing interpretations","Collection extent, internal appearance and change over time","Temporal relationships to trauma, procedures or other suspected bleeding contributors","Associated testicular integrity and perfusion findings relevant to this episode","Clinician-directed management, reassessment and episode outcomes"],"out":["Intratesticular, epididymal and scrotal-wall haematomas as independent conditions","Non-haemorrhagic hydrocele and pyocele as independent conditions","Testicular rupture, torsion and neoplasm as independently modelled disorders","Systemic bleeding disorders and anticoagulant prescribing","General scrotal anatomy and ultrasound equipment specifications","Operative technique and broader fertility management"],"boundaries":[]},"distinguishingFeatures":["Require evidence locating the collection between the tunica vaginalis layers; blood within testicular tissue or the scrotal wall belongs to a neighbouring haematoma model. See [anatomical and imaging review](https://pmc.ncbi.nlm.nih.gov/articles/PMC3846954/).","Require evidence supporting blood rather than merely documenting fluid in the correct compartment; simple hydrocele is not sufficient.","Do not identify haematocele solely from complex fluid echoes: ultrasound may not distinguish it from pyocele or exudative hydrocele. See [ultrasonography study](https://pubmed.ncbi.nlm.nih.gov/3909598/).","Assess tunica albuginea integrity separately: a haematocele and a testicular rupture are distinct findings that may coexist. See [operative correlation study](https://pubmed.ncbi.nlm.nih.gov/18242364/).","Keep an unresolved solid or vascular component under differential assessment rather than automatically classifying the entire scrotal mass as collected blood."],"structure":{"bundles":[{"id":"compartment-and-blood-identification","name":"Compartment and blood identification","description":"Establish whether the observed abnormality belongs to the tunica vaginalis space and whether its contents support haematocele.","layers":[{"id":"tunica-vaginalis-localisation","name":"Tunica vaginalis localisation","description":"Separate the peritesticular cavity from the testicular substance and scrotal wall.","findings":[{"id":"collection-compartment","name":"Collection compartment","description":"Record the affected side, anatomical boundaries and evidence supporting localisation between the tunica vaginalis layers.","questions":[{"text":"What observation places the collection between the visceral and parietal tunica vaginalis rather than within the testis or scrotal wall?","id":"collection-compartment-q01","kind":"boundary"},{"text":"Which examination or operative report establishes the side and compartment, and when was it obtained?","id":"collection-compartment-q02","kind":"provenance"}]}]},{"id":"haemorrhagic-content-evidence","name":"Haemorrhagic content evidence","description":"Separate evidence of blood from nonspecific findings of complex fluid.","findings":[{"id":"blood-versus-other-fluid","name":"Blood versus other fluid","description":"Record why the collection is interpreted as blood, the strength of that interpretation and unresolved fluid mimics.","questions":[{"text":"Is the blood interpretation based on imaging and history, direct operative observation or another documented basis?","id":"blood-versus-other-fluid-q01","kind":"provenance"},{"text":"What evidence distinguishes this collection from hydrocele or pyocele, and which alternatives remain unresolved?","id":"blood-versus-other-fluid-q02","kind":"boundary"},{"text":"What evidence standard is being used to call this episode confirmed rather than suspected?","id":"blood-versus-other-fluid-q03","kind":"definition"}]}]}]},{"id":"bleeding-origin-and-episode-course","name":"Bleeding origin and episode course","description":"Represent how the collection arose and how its extent and appearance develop.","layers":[{"id":"onset-and-causal-context","name":"Onset and causal context","description":"Connect onset to documented events while retaining uncertainty about the bleeding source.","findings":[{"id":"precipitating-event-and-source","name":"Precipitating event and bleeding source","description":"Record preceding trauma or procedures, other proposed contributors and whether the actual source of bleeding was identified.","questions":[{"text":"When did symptoms or swelling begin relative to any recorded trauma or procedure?","id":"precipitating-event-and-source-q01","kind":"provenance"},{"text":"Was a bleeding source directly identified, or is the proposed cause inferred from the history?","id":"precipitating-event-and-source-q02","kind":"provenance"},{"text":"Which unexplained features warrant clinician investigation of an alternative contributor?","id":"precipitating-event-and-source-q03","kind":"action"}]}]},{"id":"collection-evolution","name":"Collection evolution","description":"Track dated measurements and internal observations without assuming that appearance determines age.","findings":[{"id":"serial-extent-and-appearance","name":"Serial extent and appearance","description":"Compare dimensions, reported clot or septations and symptoms using identifiable examination methods.","questions":[{"text":"What are the collection dimensions at each examination, and how were any volume estimates calculated?","id":"serial-extent-and-appearance-q01","kind":"measurement"},{"text":"Do comparable examinations show enlargement, stability or regression, and how certain is that comparison?","id":"serial-extent-and-appearance-q02","kind":"measurement"},{"text":"Is the assigned episode duration supported by history, or inferred only from imaging appearance?","id":"serial-extent-and-appearance-q03","kind":"provenance"}]}]}]},{"id":"adjacent-testis-and-diagnostic-threats","name":"Adjacent testis and diagnostic threats","description":"Preserve assessment of the testis and alternative explanations despite the surrounding collection.","layers":[{"id":"testicular-integrity-and-perfusion","name":"Testicular integrity and perfusion","description":"Record structural and perfusion findings independently of the haematocele label.","findings":[{"id":"underlying-testis-assessment","name":"Underlying testis assessment","description":"Capture tunica albuginea continuity, testicular contour and perfusion, including limitations caused by incomplete visualisation.","questions":[{"text":"Was the tunica albuginea adequately assessed, and was any breach or abnormal testicular contour reported?","id":"underlying-testis-assessment-q01","kind":"measurement"},{"text":"What did Doppler assessment establish about testicular perfusion, and what technical limitations were recorded?","id":"underlying-testis-assessment-q02","kind":"measurement"},{"text":"Do the findings or assessment limitations require urgent clinician evaluation for associated injury?","id":"underlying-testis-assessment-q03","kind":"action"}]}]},{"id":"unresolved-scrotal-abnormalities","name":"Unresolved scrotal abnormalities","description":"Keep coexisting disorders and mimics visible until specifically evaluated.","findings":[{"id":"residual-differential","name":"Residual differential","description":"Record suspected infection, torsion or a separate mass as unresolved or linked conditions rather than absorbing them into the haematocele.","questions":[{"text":"Which symptoms or imaging components remain unexplained by a tunica vaginalis blood collection?","id":"residual-differential-q01","kind":"boundary"},{"text":"Is there a separately localised solid or vascular component requiring its own diagnostic assessment?","id":"residual-differential-q02","kind":"boundary"},{"text":"What follow-up or additional assessment has the clinician specified to resolve these uncertainties?","id":"residual-differential-q03","kind":"action"}]}]}]},{"id":"management-and-resolution","name":"Management and resolution","description":"Represent the clinician's response to the collection and evidence that the episode has improved or ended.","layers":[{"id":"clinical-decision-and-reassessment","name":"Clinical decision and reassessment","description":"Link the selected management approach to the observed collection, symptoms and testicular assessment.","findings":[{"id":"documented-management-plan","name":"Documented management plan","description":"Record observation or intervention as a clinician decision with its rationale, responsible service and reassessment conditions.","questions":[{"text":"What management approach was selected, by whom, and on what evidence about symptoms, collection extent and associated injury?","id":"documented-management-plan-q01","kind":"action"},{"text":"What changes in pain, swelling, examination or imaging should trigger earlier reassessment under the documented plan?","id":"documented-management-plan-q02","kind":"action"},{"text":"When and how will the collection and underlying testis next be assessed?","id":"documented-management-plan-q03","kind":"action"}]}]},{"id":"episode-outcome","name":"Episode outcome","description":"Distinguish symptom improvement from documented disappearance of the collection.","findings":[{"id":"resolution-persistence-or-recurrence","name":"Resolution, persistence or recurrence","description":"Track residual collection, symptom burden and testicular observations, preserving uncertainty when follow-up is incomplete.","questions":[{"text":"What clinical or imaging evidence supports resolution, and does any residual collection remain?","id":"resolution-persistence-or-recurrence-q01","kind":"measurement"},{"text":"If blood reappears, what evidence distinguishes a new episode from persistence or rebleeding of the original collection?","id":"resolution-persistence-or-recurrence-q02","kind":"boundary"},{"text":"Which unresolved collection or testicular findings require continued follow-up?","id":"resolution-persistence-or-recurrence-q03","kind":"action"}]}]}]},{"id":"evidence-and-external-alignment","name":"Evidence and external alignment","description":"What the world already says about this thing, gathered so the model can be checked against it.","layers":[{"id":"reported-evidence","name":"Reported evidence","description":"Findings from the breadth pass, kept separate from the structural claims.","findings":[{"id":"evidence-confidence-notes","name":"Check these first","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these check these first hold for the sense of haematocele of tunica vaginalis testis this model covers, and on what evidence?","id":"evidence-confidence-notes-q01","kind":"provenance"}]},{"id":"evidence-kinds","name":"Kinds and varieties","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these kinds and varieties hold for the sense of haematocele of tunica vaginalis testis this model covers, and on what evidence?","id":"evidence-kinds-q01","kind":"provenance"}]},{"id":"evidence-real-world-use","name":"Real-world use","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these real-world use hold for the sense of haematocele of tunica vaginalis testis this model covers, and on what evidence?","id":"evidence-real-world-use-q01","kind":"provenance"}]},{"id":"evidence-failure-modes-and-hazards","name":"Failure modes and hazards","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these failure modes and hazards hold for the sense of haematocele of tunica vaginalis testis this model covers, and on what evidence?","id":"evidence-failure-modes-and-hazards-q01","kind":"provenance"}]},{"id":"evidence-regional-variation","name":"Regional variation","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these regional variation hold for the sense of haematocele of tunica vaginalis testis this model covers, and on what evidence?","id":"evidence-regional-variation-q01","kind":"provenance"}]},{"id":"evidence-neighbours","name":"Neighbouring kinds and how to tell them apart","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these neighbouring kinds and how to tell them apart hold for the sense of haematocele of tunica vaginalis testis this model covers, and on what evidence?","id":"evidence-neighbours-q01","kind":"provenance"}]}]}]}]},"agentConduct":{"may":["Explain the condition in general terms from reputable medical sources.","Advise a person with scrotal swelling or pain after injury to seek prompt medical care."],"mustNot":["Diagnose the condition or rule out testicular torsion or cancer for a specific person.","Recommend treatment or advise against surgery for a specific person.","Disclose a person's diagnosis without consent.","Request or share intimate images except within a clinical service the person has chosen."],"requiresHuman":["Any treatment or surgical decision."]},"ethics":{"considerations":["Genital conditions carry embarrassment that can delay care; dignity and privacy matter.","Delay in seeing a doctor can cost the testis or miss a tumour."],"affectedParties":["Patients","Their partners"]},"owners":{"steward":"Nobody owns the condition; patients and their clinicians answer for care.","roles":[],"masterSystems":[]},"relations":[{"target":"Q1642062","type":"parent","note":"registry parent class"},{"target":"Q7705854","type":"parent","note":"registry parent class"}],"interaction":{"identity":{"applicability":"required","items":["Vercy registry: vr.tr.haematocele-of-tunica-vaginalis-testis","Wikidata: Q1620444 (https://www.wikidata.org/wiki/Q1620444)"]},"properties":{"applicability":"not-applicable","items":["Affected side and compartment: left, right, bilateral or unresolved; localisation confirmed, suspected or indeterminate","Diagnostic confidence: suspected, probable, confirmed, indeterminate or excluded; with evidence basis","Collection dimensions: three dimensions in mm; optional estimated volume in mL with method and examination date","Internal collection appearance: reported echogenicity, debris, septations, fluid levels and suspected clot; unknown permitted","Episode timing and trajectory: onset date or interval; enlarging, stable, regressing, resolved or indeterminate","Preceding event or bleeding contributor: linked trauma, procedure, bleeding disorder, medication exposure or other proposed contributor; temporal and causal confidence recorded","Adjacent testicular perfusion: preserved, reduced, absent or indeterminate according to the interpreting clinician","Tunica albuginea integrity: appears intact, breach suspected, breach confirmed or not adequately assessed","Pain and local symptom burden: pain score with named scale, observation time and accompanying swelling or tenderness"]},"recognition":{"applicability":"optional","items":["Visible scrotal enlargement with bruising can raise suspicion but does not distinguish this condition from other injuries.","Ultrasound may show a complex fluid collection surrounding the testis within the tunica vaginalis.","Internal echoes, septations or fluid levels can help distinguish blood-containing fluid from a simple clear-fluid collection, although these findings are not specific."]},"capabilities":{"applicability":"required","items":["Assemble an evidence-linked episode record distinguishing observed fluid from inferred blood.","Compare serial collection measurements and symptoms while flagging incompatible measurement methods.","Link the episode to suspected causes and independently modelled associated injuries.","Identify incomplete assessments of testicular integrity or perfusion for clinician review.","Track the clinician's management decision, reassessment conditions and documented outcome."]},"hazards":{"applicability":"required","items":["Can follow injury or surgery and may hide a testicular tumour.","Large or infected collections can damage the testis."]},"interfaces":{"applicability":"required","items":["International Classification of Diseases (ICD-11), World Health Organization."]},"context":{"applicability":"required","items":["This condition is encountered in assessment of scrotal swelling or pain, particularly after trauma or surgery.","It is documented during clinical examination and imaging to distinguish a blood collection from other causes of scrotal enlargement and assess associated injury."]}},"sources":[{"title":"Wikidata item Q1620444: haematocele of tunica vaginalis testis","url":"https://www.wikidata.org/wiki/Q1620444","note":"identity and sense of the item"},{"title":"Wikipedia: Hematocele","url":"https://en.wikipedia.org/wiki/Hematocele","note":"general description of the item"}],"openQuestions":["What evidence standard should distinguish suspected, probable and confirmed haematocele when direct inspection is unavailable?","How should blood-stained hydrocele and haemorrhage into a pre-existing hydrocele map to this registry entry without duplicating neighbouring models?","Which measurement methods and change thresholds reliably distinguish collection growth from ultrasound measurement variability?","Which management and reassessment criteria are supported for traumatic, postoperative and unexplained presentations across different age groups?","What findings and follow-up duration justify closing a persistent or organised haematocele episode when an underlying lesion has not been conclusively excluded?"],"resources":{"spec":"/models/things/publications/thing-q1620444/spec.json"},"provenance":{"origin":"thing registry research (pass 2)","builtFrom":["models/things/publications/thing-q1620444/spec.json"],"providers":["Codex"],"researchStatus":"unreviewed","generatedAt":"2026-09-12T10:09:03Z","builder":"tools/build_cards.py@1.0.0"},"completeness":{"sections":{"classifiers":"filled","whatItIs":"filled","purpose":"filled","distinguishingFeatures":"filled","structure":"filled","agentConduct":"filled","ethics":"filled","owners":"filled","relations":"filled","interaction.identity":"filled","interaction.properties":"not-applicable","interaction.recognition":"filled","interaction.capabilities":"filled","interaction.hazards":"filled","interaction.interfaces":"filled","interaction.context":"filled","sources":"filled"},"notes":{"_gate":"Published through the thing publication gate 1.0 on 2026-10-07T10:10:26+00:00: completeness 1.00; sense: Wikidata description; 2 live sources; review by codex: pass","interaction.properties":"Plane INF: no invented physical properties."},"score":1.0}}