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Case of the Month

January 2009

Patient Data: 18 year old male

Clinical Info: Painful scrotal swelling after trauma


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Longitudinal image of the testis with an intratesticular hematoma and a hematocele


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Transverse image showing an inhomogeneous hypoechoic hematocele surrounding the testis


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Detail of the testis with a hypoechoic linear lesion consistent with a testis fracture (arrows)


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Detail of the testis with a hypoechoic linear lesion consistent with a testis fracture (arrows)


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Longitudinal image of the fractured testis with testis hematoma and hematocele

Trauma to the testis is uncommon because of its mobility and position. Trauma can be penetrating or blunt (more common). Impingement of the testis against the pelvis is the most common mechanism of injury resulting from blunt trauma. More than 50% of testicular ruptures occur during sporting events. Motor vehicle accidents account for 9-17% of testicular injuries. In this case the patient had an accident with his scooter
Testicular trauma occurs most commonly in the younger age group between 16-20 years, however, it can occur at any age.
Testicular rupture is an urologic emergency, and more than 80% of ruptured testes can be saved if surgery is performed within 72 hours.

For more examples of traumatic scrotal lesions see

References
Deurdulian C, Mittelstaedt CA, Chong WK, Fielding JR. US of acute scrotal trauma: optimal technique, imaging findings, and management Radiographics. 2007 Mar-Apr;27(2):357-69. Review.

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