Intratesticular Hematoma

Case contributed by Dr Karina Dorfman

Presentation

Right testicular trauma. The first ultrasound examination was performed about half an hour after the accident.

Patient Data

Age: 40 years
Gender: Male
Ultrasound

First ultrasound examination (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.

Ultrasound

Second ultrasound examination (on the next day after the accident)

Follow up examination on the next day after the trauma shows a prominent hypoechogenic area in the inferior pole of right testis, without color Doppler flow in that area.

Ultrasound

Third ultrasound examination (two weeks 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.

Ultrasound

Fourth ultrasound examination (six weeks after the accident)

Follow up ultrasound test, six weeks after the accident, shows subtle hypoechogenic focus in the inferior pole of right testis, with the recovery of color Doppler flow,

Ultrasound

Fifth ultrasound examination (three months after the accident)

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.

PlayAdd to Share

Case information

rID: 70022
Published: 23rd Aug 2019
Last edited: 27th Aug 2019
Inclusion in quiz mode: Included
Institution: Bnai Zion Medical Center

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.