Acute pancreatitis is a common diagnosis. Although extremely rare, extravasated pancreatic fluid has the potential to third space into the peritoneal cavity or retroperitoneal space. We report the case of a 33-year-old male with idiopathic subacute pancreatitis who developed acute scrotal pain and swelling. Computer tomography of the abdomen/pelvis revealed tracking of peritoneal fluid into the scrotum consistent with a pancreatic hydrocele, confirmed by ultrasound. He was taken to the operating room for exploration and evacuation of the scrotal hydrocele. This case highlights the importance of active surveillance for the potential development of a scrotal hydrocele in acute pancreatitis.
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