Presentation
Post-traumatic scrotal swelling and groin pain increasing over time for two weeks with fever and fatigue.
Patient Data
Enlarged right testicle with heterogeneous geographic appearance, irregular ill-defined margins and lack of vascularity consistent with testicular rupture.
Distended scrotal sac on the affected side due to excessive pyocele (viscous fluid with multiple thick septa and adhesions resembling "honeycombs").
Left testicle is normal in size, echotexture and vascularity, surrounded by a small amount of clear fluid (hydrocele). Diffuse scrotal edema.
Circumferential urinary bladder wall thickening suggestive of chronic hypertrophic cystitis in the setting of outlet obstruction due to prostate hypertrophy.
Note the intravesical catheter balloon and the diverticulum outpouching from the left bladder wall.
Case Discussion
A case of testicular rupture with resultant scrotal pyocele. Orchiectomy revealed a ruptured testicle (tunica albuginea tear and extensive testicular necrosis) floating in purulent fluid with putrid odor.
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