Presentation
Right testicular trauma. The first ultrasound examination was performed about half an hour after the accident.
Patient Data
1st US exam half an hour after the accident
A subtle hypoechogenic area in the inferior pole of the right testis with preserved color Doppler flow.
No evidence of testicular rupture or hydrocele.
2nd US exam on the next day after the accident
Follow up examination on the next day after the trauma shows a prominent hypoechoic area in the inferior pole of right testis, without color Doppler flow in that area.
3rd US exam 2 wk after the accident
Follow up ultrasound examination, two weeks after the trauma, shows a heterogeneous area in the inferior pole of the right testis with mildly diminished color Doppler flow.
4th US exam 6 wk after the accident
Follow up ultrasound test, six weeks after the accident, shows subtle hypoechoic focus in the inferior pole of right testis, with the recovery of color Doppler flow,
Follow up ultrasound examination, three months after the accident, shows resolution of the findings.
Case Discussion
This case presents the classic imaging findings of intratesticular hematoma during different stages of hematoma evolution.
First ultrasound examination, about half an hour after the trauma, shows subtle ill-defined hypoechogenic area, that becomes more defined on the next day. Ultrasound examinations two weeks and six weeks after the trauma show progressive resolution of the findings, with complete disappearance of the findings three months after the trauma.
This case emphasizes the contribution of close follow up of a patient with testicular trauma, as the initial examination, when performed shortly after the trauma may show only mild findings. The follow-up examinations reveal the full extent of the injury.
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