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Intratesticular hematoma after blunt scrotal trauma: a case series and algorithm-based approach to management.

Bowen DK, Gonzalez CM - Cent European J Urol (2014)

Bottom Line: We present our experience with intratesticular hematoma (ITH) without rupture of the tunica albuginea following blunt scrotal trauma and present an algorithm for management.Time from the incident to presentation ranged from 5 hours to 4 days.Two patients underwent surgical exploration and all patients had resolution of pain within one to two days.

View Article: PubMed Central - PubMed

Affiliation: Northwestern University, Department of Urology, Chicago, United States.

ABSTRACT
We present our experience with intratesticular hematoma (ITH) without rupture of the tunica albuginea following blunt scrotal trauma and present an algorithm for management. We reviewed the charts of 3 patients who presented between 2006 and 2013 with this finding. Time from the incident to presentation ranged from 5 hours to 4 days. All patients underwent at least one scrotal ultrasound reviewed by the same urologist. Two patients underwent surgical exploration and all patients had resolution of pain within one to two days. Management of ITH should be centered on the patient's pain severity as well as serial ultrasound findings.

No MeSH data available.


Related in: MedlinePlus

Scrotal ultrasound of 29 year old baseball player found to have ITH with intact tunica albuginea. Arrow = ITH.
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Figure 0001: Scrotal ultrasound of 29 year old baseball player found to have ITH with intact tunica albuginea. Arrow = ITH.

Mentions: A 29–year old baseball player presented to the emergency department 6 hours after he was hit in the scrotum with a baseball. He exited the game due to 10/10 pain radiating to the inguinal area with mild nausea. Physical exam was notable for a non–displaced right testis that was indurated and tender to palpation with no discernible rupture. Ultrasound showed an intact TA with an area of heterogeneous echotexture measuring 2.0 x 0.8 x 1.6 cm with no flow (Figure 1). He was observed in the emergency department and an ultrasound was repeated 1 hour later. The hypoechoic area was noted to have expanded thus he was taken to the operating room where an ITH with an intact TA was found. The clot was evacuated and the nonviable seminiferous tubules were debrided. He had an unremarkable postoperative course.


Intratesticular hematoma after blunt scrotal trauma: a case series and algorithm-based approach to management.

Bowen DK, Gonzalez CM - Cent European J Urol (2014)

Scrotal ultrasound of 29 year old baseball player found to have ITH with intact tunica albuginea. Arrow = ITH.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4310892&req=5

Figure 0001: Scrotal ultrasound of 29 year old baseball player found to have ITH with intact tunica albuginea. Arrow = ITH.
Mentions: A 29–year old baseball player presented to the emergency department 6 hours after he was hit in the scrotum with a baseball. He exited the game due to 10/10 pain radiating to the inguinal area with mild nausea. Physical exam was notable for a non–displaced right testis that was indurated and tender to palpation with no discernible rupture. Ultrasound showed an intact TA with an area of heterogeneous echotexture measuring 2.0 x 0.8 x 1.6 cm with no flow (Figure 1). He was observed in the emergency department and an ultrasound was repeated 1 hour later. The hypoechoic area was noted to have expanded thus he was taken to the operating room where an ITH with an intact TA was found. The clot was evacuated and the nonviable seminiferous tubules were debrided. He had an unremarkable postoperative course.

Bottom Line: We present our experience with intratesticular hematoma (ITH) without rupture of the tunica albuginea following blunt scrotal trauma and present an algorithm for management.Time from the incident to presentation ranged from 5 hours to 4 days.Two patients underwent surgical exploration and all patients had resolution of pain within one to two days.

View Article: PubMed Central - PubMed

Affiliation: Northwestern University, Department of Urology, Chicago, United States.

ABSTRACT
We present our experience with intratesticular hematoma (ITH) without rupture of the tunica albuginea following blunt scrotal trauma and present an algorithm for management. We reviewed the charts of 3 patients who presented between 2006 and 2013 with this finding. Time from the incident to presentation ranged from 5 hours to 4 days. All patients underwent at least one scrotal ultrasound reviewed by the same urologist. Two patients underwent surgical exploration and all patients had resolution of pain within one to two days. Management of ITH should be centered on the patient's pain severity as well as serial ultrasound findings.

No MeSH data available.


Related in: MedlinePlus