Testicular trauma

Testicular trauma is the third most-common cause of acute scrotal pain and may result in various degree of damage to the testes.

Testicular rupture and testicular ischaemia/infarct are two severe complications which need to be ruled out. Other injuries that can occur include 1:

Associated extra-testicular injuries (e.g. epididymis fracture, epididymitis, scrotal wall haematoma, haematocoeles) can also commonly occur 3

Radiographic features

Ultrasound
Testicular rupture
  • haematocoele is usually present
  • assess for disruption of the tunica albuginea, which is normally a smooth echogenic line
    • signs of disruption include loss of continuity, crinkling, or retraction
  • extrusion of the seminiferous tubules can occur (and may mimic a complex haematocoele)
    • assess with Doppler as seminiferous tubules should retain arterial blood supply to differentiate between this and a complex haematocoele
Testicular ischaemia/infarct
  • a heterogenous testis suggests patchy testicular ischaemia or infarct
  • ultrasound imaging features are similar to testicular torsion but the pathogenesis is different; post-traumatic infarct is due to increased intra-testicular pressure resulting in venous obstruction and venous infarction
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Article Information

rID: 30587
System: Urogenital
Section: Gamuts
Synonyms or Alternate Spellings:
  • Testicular rupture

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Cases and Figures

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    Case 1: intra-testicular haematoma
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    Case 2
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    Case 3
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    Case 4
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