Presentation
Right scrotal injury following a heavy object falling at the right inguinal area on a young male patient at a construction site.
Patient Data
A large, heterogeneous fluid content (acute hematoma) approximating 25 ml in volume is noted within the right inguinal canal, enveloping a visibly edematous right spermatic cord, of which ipsilaterally demonstrates insignificant vascular signals on color Doppler imaging.
The right testis is within the right scrotal sac, and shows no vascularity, albeit with homogenous parenchymal reflectivity with no overt contusion or fractures or obvious disruptions along the tunica albuginea. It is of normal size (11 ml in volume) and shape.
The left testis is displaced into the contralateral distal left inguinal canal but with normal size (10.5 ml), shape and parenchymal echo/vascular pattern.
Case Discussion
Acute right-sided testicular torsion (post-traumatic) was favored sonographically. This was confirmed operatively.
Also, during the exploration, a large right inguinal hematoma encasing the right spermatic cord plus left-sided viable testis, though with a testicular bruise- grade 1, was confirmed. A slow muscle bleed at the right inguinal region was noted.
Subsequently, right orchiectomy and left orchidopexy was carried out.
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