Hospital: Hospital Universitario Central de Asturias.
Ciudad:
Nº:
Aut@r o Autores: D. García-Pérez, N. Sordo-Alonso, J. Calvo-Blanco, C. Suárez-Arcay, S. GonzálezSánchez, F. García-Arias.,
Presentación:
A 21 years-old male is admitted to the Emergency Department referring scrotal trauma, with testicular pain, radiating to the hypogastric area and nausea. Physical examination revealed an indurate, enlarged and painful left testicle. A testicular ultrasound was requested. FINDINGS: Enlargement and heterogeneous echotexture of left teste with disruption of the tunica albuginea and abnormality in the contour were seen. Intratesticular and extratesticular haematomas were also identified and no signs of testicular torsion.
Discusión:
Diagnosis: testicular rupture. Testicular trauma is the third most common cause of acute scrotal pain. US is the main technique for evaluation due to it reliable depicts tunica albuginea rupture, intra and extratesticular haematomas and testicular torsion. Technique: A7-14 MHz High-frequency US performed with a linear-array transducer and Color Doppler mode. US findings in testicular ruptura: Disruption of the tunica albuginea: normal tunica albuginea appears as two parallel hyperechoic layers outlanding the teste. This is the most relevant sign. Contour abnormality of the teste: results from the extrusion o fthe testicular parenchyma through disrupted tunica albuginea. Heterogeneous echotexture of the teste: when the tunica is disptured, the underlying testicular parenchyma is injured, but it should not be considered a testicular rupture sign if an intact albuginea is seen or if the testicular contour is regular. Absence of vascularity: rupture of the teste may result in a loss of vascularity to a portion or the entirety of the teste. This condition may help to determine the viability of the teste and the appropriate surgical method. Small hematomas require conservative management but a testicular rupture is a surgical emergency.
Conclusión:
Diagnosis: testicular rupture. Testicular trauma is the third most common cause of acute scrotal pain. US is the main technique for evaluation due to it reliable depicts tunica albuginea rupture, intra and extratesticular haematomas and testicular torsion. Technique: A7-14 MHz High-frequency US performed with a linear-array transducer and Color Doppler mode. US findings in testicular ruptura: Disruption of the tunica albuginea: normal tunica albuginea appears as two parallel hyperechoic layers outlanding the teste. This is the most relevant sign. Contour abnormality of the teste: results from the extrusion o fthe testicular parenchyma through disrupted tunica albuginea. Heterogeneous echotexture of the teste: when the tunica is disptured, the underlying testicular parenchyma is injured, but it should not be considered a testicular rupture sign if an intact albuginea is seen or if the testicular contour is regular. Absence of vascularity: rupture of the teste may result in a loss of vascularity to a portion or the entirety of the teste. This condition may help to determine the viability of the teste and the appropriate surgical method. Small hematomas require conservative management but a testicular rupture is a surgical emergency.
Bibliografía:
– Cannis M, Mailhot T, Perera P. Besideultrasound in a case ofbluntscrotal trauma. West J EmergMed. 2013, 14 (2): 127-129. – Bhatt S, Dogra VS. Role of US in testicular and scrotal trauma. RadioGraphics 2008, 28: 1617-1629.