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More Like This ? Testicular Rupture
Topic ID: 4560 - Modified: 2008-08-04 18:48:53-04 - Created: 2003-01-24 04:46:19-05
ACR Index: 8.4

The risk of testicular rupture following major scrotal blunt trauma is as high as 50% with common etiologies including physical assaults, sports injuries and motor vehicle accidents. The majority of cases are unilateral, but bilateral involvement can be seen in 1-2% of cases. The mechanism of testicular rupture is felt to be due to trapping of the testicle against the bony pelvis or adjacent thigh with subsequent transmission of force to the testicle, resulting in rupture.

While no symptoms are specific for testicular rupture, common presenting signs include testicular pain in conjunction with a history of trauma, scrotal ecchymosis, and hematocele. Sonographic evaluation with a 7.5-MHz transducer can be a useful adjunct to physical examination and typical abnormal findings in the case of rupture include parenchymal heterogeneity and loss of tunical continuity. Hematoceles are frequently seen concurrently. Additionally, trauma increases the risk of torsion, therefore evaluation of testicular blood flow is necessary. Visualization of a normal testes on US virtually excludes significant injury.

Management of suspected testicular rupture is surgical exploration with prompt repair of the defect. Rapid intervention is essential, with one study demonstrating 80% salvage rate when repair was accomplished within 3 days of injury. Beyond that period, the risk of ischemic necrosis and abscess formation increases sizably with less than a third of cases responding favorably if repair is delayed greater than 9 days.

Topic Contributor Credits

Topic Submitted by: Kevin Banks - Author Info
Affiliation: Brooke Army Medical Center
Topic approved by: Dawn E Light - Editor Info
Affiliation: Childrens Hospital of Dayton, OH

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