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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 27 year old hockey player with ITH and incidental epidermoid cyst. Large Arrow = ITH. Small Arrow = Epidermoid Cyst.
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Figure 0002: Scrotal ultrasound of 27 year old hockey player with ITH and incidental epidermoid cyst. Large Arrow = ITH. Small Arrow = Epidermoid Cyst.

Mentions: A 27–year old hockey player presented to the emergency department 5 hours after he was struck in the scrotum by a puck. He had moderate pain and his left hemi–scrotum was mildly swollen and tender with no palpable scrotal hematoma or testicular rupture. His scrotal ultrasound showed an intact left TA, good flow to the parenchyma, and a heterogeneous hypoechoic well–circumscribed region measuring 2.6 x 1.5 x 2.3 cm with no internal flow. Within this region there was a smaller round nodule with a hyperechoic rim, believed to represent an epidermoid cyst (Figure 2). Given that his scrotal exam was relatively benign and his pain could be controlled with oral narcotics, he was managed conservatively. An ultrasound the following day showed no interval expansion, and on ultrasound 3 weeks later, resolution of the small nodule within the ITH was noted, as well as continued good blood flow to the testis. He returned to the line–up and played one week after the injury.


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 27 year old hockey player with ITH and incidental epidermoid cyst. Large Arrow = ITH. Small Arrow = Epidermoid Cyst.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 0002: Scrotal ultrasound of 27 year old hockey player with ITH and incidental epidermoid cyst. Large Arrow = ITH. Small Arrow = Epidermoid Cyst.
Mentions: A 27–year old hockey player presented to the emergency department 5 hours after he was struck in the scrotum by a puck. He had moderate pain and his left hemi–scrotum was mildly swollen and tender with no palpable scrotal hematoma or testicular rupture. His scrotal ultrasound showed an intact left TA, good flow to the parenchyma, and a heterogeneous hypoechoic well–circumscribed region measuring 2.6 x 1.5 x 2.3 cm with no internal flow. Within this region there was a smaller round nodule with a hyperechoic rim, believed to represent an epidermoid cyst (Figure 2). Given that his scrotal exam was relatively benign and his pain could be controlled with oral narcotics, he was managed conservatively. An ultrasound the following day showed no interval expansion, and on ultrasound 3 weeks later, resolution of the small nodule within the ITH was noted, as well as continued good blood flow to the testis. He returned to the line–up and played one week after the injury.

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