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Testicular Trauma
Hank Baskin, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Hydrocele: Simple fluid between layers of tunica vaginalis
              • Hematocele: Blood products between layers of tunica vaginalis
              • Hematoma: Contained collection of blood products within testis, epididymis, or scrotal wall; can be multifocal
              • Testicular fracture: Disruption of testicular parenchyma
              • Testicular rupture: Disruption of tunica albuginea, often with extrusion of testicular parenchyma
              • Devascularization: Vascular pedicle injury causing absent or diminished blood flow without true torsion (twisting)
              • Traumatic epididymitis: Epididymal contusion causing inflammation, enlargement, & hypervascularity
              • Traumatic testicular ectopia: Traumatic dislocation of testis into inguinal canal, abdominal cavity, or perineum

            IMAGING

            • General Features

              • Ultrasonographic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      • Reporting Tips

                                        Selected References

                                        1. Dalton DM et al: Aetiology, epidemiology and management strategies for blunt scrotal trauma. Surgeon. 14(1):18-21, 2016
                                        2. Wright S et al: Emergency ultrasound of acute scrotal pain. Eur J Emerg Med. 22(1):2-9, 2015
                                        3. Gómez RG et al: Traumatic testicular dislocation. Int Urol Nephrol. 46(10):1883-7, 2014
                                        4. Pesch MH et al: The case of the missing testicle: blunt scrotal trauma in the pediatric emergency department. Pediatr Emerg Care. 30(11):824-5, 2014
                                        5. D'Andrea A et al: US in the assessment of acute scrotum. Crit Ultrasound J. 5 Suppl 1:S8, 2013
                                        6. Delaney LR et al: Ultrasound of the pediatric scrotum. Semin Ultrasound CT MR. 34(3):248-56, 2013
                                        7. Matzek BA et al: Traumatic testicular dislocation after minor trauma in a pediatric patient. J Emerg Med. 45(4):537-40, 2013
                                        8. Rao MS et al: Sonography of scrotal trauma. Indian J Radiol Imaging. 22(4):293-7, 2012
                                        9. Widni EE et al: Analysis of nonsexual injuries of the male genitals in children and adolescents. Acta Paediatr. 100(4):590-3, 2011
                                        10. Cubillos J et al: A conservative approach to testicular rupture in adolescent boys. J Urol. 184(4 Suppl):1733-8, 2010
                                        11. Bhatt S et al: Role of US in testicular and scrotal trauma. Radiographics. 28(6):1617-29, 2008
                                        12. Lee SH et al: Trauma to male genital organs: a 10-year review of 156 patients, including 118 treated by surgery. BJU Int. 101(2):211-5, 2008
                                        13. Deurdulian C et al: US of acute scrotal trauma: optimal technique, imaging findings, and management. Radiographics. 27(2):357-69, 2007
                                        14. Buckley JC et al: Diagnosis and management of testicular ruptures. Urol Clin North Am. 33(1):111-6, vii, 2006
                                        15. Buckley JC et al: Use of ultrasonography for the diagnosis of testicular injuries in blunt scrotal trauma. J Urol. 175(1):175-8, 2006
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Definitions

                                                    • Hydrocele: Simple fluid between layers of tunica vaginalis
                                                    • Hematocele: Blood products between layers of tunica vaginalis
                                                    • Hematoma: Contained collection of blood products within testis, epididymis, or scrotal wall; can be multifocal
                                                    • Testicular fracture: Disruption of testicular parenchyma
                                                    • Testicular rupture: Disruption of tunica albuginea, often with extrusion of testicular parenchyma
                                                    • Devascularization: Vascular pedicle injury causing absent or diminished blood flow without true torsion (twisting)
                                                    • Traumatic epididymitis: Epididymal contusion causing inflammation, enlargement, & hypervascularity
                                                    • Traumatic testicular ectopia: Traumatic dislocation of testis into inguinal canal, abdominal cavity, or perineum

                                                  IMAGING

                                                  • General Features

                                                    • Ultrasonographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          • Image Interpretation Pearls

                                                                            • Reporting Tips

                                                                              Selected References

                                                                              1. Dalton DM et al: Aetiology, epidemiology and management strategies for blunt scrotal trauma. Surgeon. 14(1):18-21, 2016
                                                                              2. Wright S et al: Emergency ultrasound of acute scrotal pain. Eur J Emerg Med. 22(1):2-9, 2015
                                                                              3. Gómez RG et al: Traumatic testicular dislocation. Int Urol Nephrol. 46(10):1883-7, 2014
                                                                              4. Pesch MH et al: The case of the missing testicle: blunt scrotal trauma in the pediatric emergency department. Pediatr Emerg Care. 30(11):824-5, 2014
                                                                              5. D'Andrea A et al: US in the assessment of acute scrotum. Crit Ultrasound J. 5 Suppl 1:S8, 2013
                                                                              6. Delaney LR et al: Ultrasound of the pediatric scrotum. Semin Ultrasound CT MR. 34(3):248-56, 2013
                                                                              7. Matzek BA et al: Traumatic testicular dislocation after minor trauma in a pediatric patient. J Emerg Med. 45(4):537-40, 2013
                                                                              8. Rao MS et al: Sonography of scrotal trauma. Indian J Radiol Imaging. 22(4):293-7, 2012
                                                                              9. Widni EE et al: Analysis of nonsexual injuries of the male genitals in children and adolescents. Acta Paediatr. 100(4):590-3, 2011
                                                                              10. Cubillos J et al: A conservative approach to testicular rupture in adolescent boys. J Urol. 184(4 Suppl):1733-8, 2010
                                                                              11. Bhatt S et al: Role of US in testicular and scrotal trauma. Radiographics. 28(6):1617-29, 2008
                                                                              12. Lee SH et al: Trauma to male genital organs: a 10-year review of 156 patients, including 118 treated by surgery. BJU Int. 101(2):211-5, 2008
                                                                              13. Deurdulian C et al: US of acute scrotal trauma: optimal technique, imaging findings, and management. Radiographics. 27(2):357-69, 2007
                                                                              14. Buckley JC et al: Diagnosis and management of testicular ruptures. Urol Clin North Am. 33(1):111-6, vii, 2006
                                                                              15. Buckley JC et al: Use of ultrasonography for the diagnosis of testicular injuries in blunt scrotal trauma. J Urol. 175(1):175-8, 2006