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Scrotal hematocele

Case contributed by Dennis Odhiambo Agolah
Diagnosis certain

Presentation

History of two days after an assault and now reports scrotal swelling and pain.

Patient Data

Age: 35 years
Gender: Male
ultrasound

Heterogeneously hypodense left scrotal sac fluid content totalling approximately 26 ml in volume, accompanied by partially disrupted and irregularly outlined supero-medial left testicular capsule (tunica albuginea) plus loss of the superior 1/3 testicular parenchymal integrity is noted, suggesting the sequel of post-traumatic fracture and an ipsilateral left scrotal sac extra testicular hematocele. The rest of the left testicular parenchyma shows a normal echopattern. The right testicle and epididymis and the right scrotal sac are unremarkable.

OPERATIVE FINDINGS

Post surgical exploration yielded left scrotal hematocele and left testicular rupture (6 cm left testicular laceration). However, both testes were confirmed to be viable.

Case Discussion

Two days post severe blunt trauma (a kick into the left groin/scrotum).

A visible, partially disrupted and architectural disturbance of the supero-medial left testicular tunica albuginea and the superior third zonal parenchyma contributing to the extensive left extra testicular, dense heterohypoechoic scrotal collection (hematocele). No significant vascular compromise of the left testicle ipsilaterally. The contralateral right hemiscrotum and testis are normal.

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