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Traumatic testicular rupture

Case contributed by Derek Smith
Diagnosis certain

Presentation

Plastic guard broke off DIY equipment and accelerated into the patient, hitting his lower abdomen and scrotum. Marked swelling and tenderness of right hemiscrotum.

Patient Data

Age: 60 years
Gender: Male

Imaged approximately 4...

ultrasound

Imaged approximately 4 hours after injury

Normal left testis and associated structures.

Rupture of right testis, with tunica albuginea defect in the inferomedial portion of the testis. The testis is approximately 50% larger in volume than the left.

Increased vascularity of the right testis, apart from at a heterogenous, hypoechoic component anteriorly with little flow, likely small contusion/hematoma.

Complex right hematocele.

Relatively preserved epididymal head.

Case Discussion

This is a case of traumatic testicular rupture.

The tunica albuginea is ruptured, with extrusion of the testis inferomedially and a complex hematocele. Increased size and vascularity, with an anterior contusion.

These findings were confirmed at urgent surgical exploration and testicular salvage was achieved.

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