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Testicular rupture

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Testicular trauma with acute left scrotal swelling and tenderness.

Patient Data

Age: 60 years
Gender: Male

MRI pelvis

mri

A well-defined oval shaped fluid intensity lesion is noted in the left hemiscrotum measuring 9.3 x 11.7 x 12.8 cm. It shows diffuse hyperintensity at T1, T2 and diffusion with diffuse hypointensity at ADC, compatible with hemorrhagic content (subacute hematocele). There are T2 hypointense threads of tissues within the subacute blood of hematocele mostly representing lacerated seminiferous tubules. There is a defect in the interface between the hematocele and the left testis. The left testis is compressed and small in size measuring 3.8 x 1.0 cm. No other left scrotal collections. Normal features of scrotal wall.

Case Discussion

Testicular rupture is a severe complication of testicular trauma. It is usually associated with scrotal hematocele that may show soft tissue structures representing the lacerated seminiferous tubules. The hematocele can be confused with intratesticular hematoma on ultrasound. 

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