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Pelvis » Scrotum And Testicles
Traumatic testicular rupture with cord hematoma
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Author(s) :
S. Manohar, MD, DMRD
 
Presentation A young man fell into a well and sustained severe acute blunt injury to the right inguinal region. Clinically he presented with a grossly edematous penis and scrotum. The swelling extended up to right inguinal region. He passed urine after the injury. There was no hematuria, perineal or suprapubic swelling. An ultrasound was performed.
 
 
 
Caption: Transverse view demonstrating both scrotal sacs
Description: A fairly large, complex collection is noted completely filling the right scrotal sac. The right testis cannot be discerned seperately from this. A small collection is also seen in the left scrotal sac. The left testis is normal.
 
 
 
Caption: Magnified image of the right scrotal contents
Description: The normal right testicular architecture appears completely disrupted and cannot be identified separately from the complex mixed echogenic collection, which represents an acute hematocele.
 
 
 
Caption: Comparative view of both the scrotal sacs
Description: The complete disruption of the right testis is very striking in this image. The complex hematocele in the right scrotal sac extended to the right inguinal region along the cord. The small collection surrounding the left testis is also noted.
 
 
 
Caption: Comparative views of both the scrotal contents
Description: The right disrupted testis within the right hematocele and the left hematocele is noted again in this image.
 
 
 
Caption: Sagittal scan of right scrotum and inguinal region
Description: The complex hematocele seen in the right scrotum appears to extend into the right inguinal region and the cord.
 
 
 
Caption: Comparative color Doppler view
Description: The left testis showed normal flow. There was no flow in the area of the right testis or in any region of the right scrotum.
 
 
 
Caption: Views of the bladder and the prostate
Description: The urinary bladder and the prostate were normal. No free fluid was noted in the abdomen.
 
Differential Diagnosis Traumatic right testicular rupture with bilateral complex hematoceles [right much larger than the left]. The right hematocele extends along the cord.
 
Final Diagnosis Traumatic testicular rupture with cord hematoma and bilateral hematoceles
 
Follow Up The findings discussed above were confirmed at surgery and a right-sided high orchiectomy was performed.
 
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