Scrotal haemorrhage

Case contributed by Dr. Mathieu Deltomme

Presentation

Patient fell with his bike and was admitted to the ER for a facial wound. After wound care he returned home. There he noticed that his left inguinoscrotal region was swollen. He returned to the ER. Patient was send to the radiology department for an ultrasound to exclude an inguinal hernia.

Patient Data

Age: 65
Gender: Male
Ultrasound

Ultrasound

Ultrasound showed a big heterogenous hyperechogenic mass in the left inguinoscrotal region. Because of the substantial size (>10cm), the abdominal probe had to be used for adequate assessment. The mass appeared to be subcutaneous and not in the inguinal canal. The testis appeared to be normal. No clear active bleeding was visualised.

CT

Triphasic CT of the lower abdomen-inguinal region

There is a big subcutaneous hematoma in the left inguinoscrotal region, with rightsided deviation of both testes.

In the arterial phase, there is a small blush of contrast, increasing in the venous phase: active arterial bleeding.

There are no intra-abdominal abnormalities.

Case Discussion

The patient was transferred to the operating room where the urologist performed surgery to coagulate the bleeding arterial branch.

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Case information

rID: 54017
Case created: 19th Jun 2017
Last edited: 21st Jun 2017
Systems: Trauma, Urogenital
Inclusion in quiz mode: Excluded

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