Emergency Ultrasound > Top 10 Pathology > Trauma to the Scrotum

Trauma to the Scrotum

Different types of trauma to the scrotum can be encountered during sonographic imaging. Most common injuries are of the blunt type and are associated with kicking to the groin, motor vehicle collision and injuries acquired during athletic activities. Infrequent types of scrotal injury include penetrating trauma with either sharp objects or high velocity missiles such as gun shot wounds, stab wounds and machinery induced degloving injury. Our focus will be on blunt traumatic injuries. Sonographic features of blunt traumatic injury include loss of the normal testicular outline, altered echo texture and a complex hydrocele, likely blood. An irregular fracture plane is sometimes visualized but is not a requirement to the diagnosis of traumatic injury to the testicle. Scrotal wall edema and hyperemia are also regularly identified. Again, salvage of an injured testicle requires prompt and accurate diagnosis and delays may hinder needed prompt and precise treatment. True rupture of the testicle occurs most often during sporting activities. Significant trauma to the testicle with fracture and/or rupture is a surgical emergency that carries good prognosis if treated within 72 hours of the episode. The presence of altered echo texture, loss of normal testicular outline and a complex hydrocele constitutes a fractured testicle in the appropriate setting of trauma (Fig 9).


Fig 9. Fracture.

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