Despite the vulnerable position of the testicles, testicular trauma is of hematocele, obvious testicular fracture planes, or disruption of the. Scrotal haematocoeles are collections of blood within the scrotal sac, but outside of the testis. Pathology A haematocele normally results from trauma to the. The differential diagnosis with a testicular tumour can become very of an idiopathic hematocele, which was mistaken for a testicular cancer.

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It consisted of a cavity having a thick capsule,filled with old brownish clotted blood fig.

We decided not to perform intraoperative frozen-section examination as the testis did not appear to be viable, and the necrotic-hemorragic appearance of the mass strongly indicated cancer.

We reviewed the charts and images of three patients who presented between and with an ITH and intact tunica albuginea TA following blunt scrotal trauma.

The aim of this paper is to describe the outcomes of three cases of ITH without testis rupture and propose a management algorithm for this rare clinical scenario based on our experience as well as on a review of the literature.

Management teaticular 53 cases of testicular trauma. This content is owned by the AAFP. His pain resolved on post—operative day 2 and at five—month follow—up his testis size remained stable with no scrotal pain. Hematocele It is defined as accumulation of blood within the tunica vaginalis. It is more common in tall, thin men and usually occurs on the left side.

Evaluation of Scrotal Masses – – American Family Physician

This gradual development of hematoceles is not unusual1. Scrotal carcinoma has also been cited as a complication of PUVA psoralen plus ultraviolet A therapy for psoriasis. The left testis and epididymis could not be detected. Also, because of its wider field of view, MRI allows for the investigation of diseases with extension beyond the scrotum, such as scrotal fistulas 4 and cryptorchidism 6. Algorithm of the likely diagnoses of a scrotal mass based on physical examination findings.


Abstract Hematoceles are usually associated with a history of scrotal trauma, are usually painful and rarely have an idiopathic origin.

Urologic and male genital cancers. The patients present with acutely swollen and painful scrotum, frequently in association with fever and leukocytosis.

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Check for errors and try again. To see the full article, log in or purchase access. A retrospective review of pediatric patients with epididymitis, testicular torsion, and torsion of testicular appendages. Although it used to be common among chimney sweeps, the disease is now fairly rare because the risks of exposure to occupational carcinogens have been recognized, and use of protective clothing and equipment has become routine.


Unable to process the form. Because varicoceles may contribute to lower sperm counts in some men, they should be considered in infertility evaluations.

Surgical options in the management of groin hernias. About Blog Go ad-free. Such collections are caused by different factors ranging from physiological events to varied diseases. Such a technique is useful in the assessment of testicular diseases. Benign lesions such as hydroceles and varicoceles are often found incidentally by the patient or physician on routine examination. National Center for Biotechnology InformationU.

MRI findings follow the pattern of methemoglobin degradation in other tissues Table 1.

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Acute scrotal symptoms in boys with an indeterminate clinical presentation: Elevation of testis may aggravate pain; abnormal testicular lie; cremasteric reflex usually absent. The large field of view provided by MRI facilitates the assessment of the lesion extent. Log in Sign up. The identification of an intact tunica albuginea allows for ruling out the presence of testicular rupture 8.

In older children, adolescents and adults, hydrocele is usually acquired and related to inflammatory processes, testicular torsion, trauma, tumor 1or may be idiopathic.


Our study is limited as a case series and by its retrospective nature, however, due to the paucity of literature in this area we feel it will aid in the management strategy of these patients.

Observe the location and delimitation of the lesion. Fortunately, with a careful history and physical examination, physicians can usually identify those patients testicupar potentially serious conditions.

Possible causes most often include direct trauma of the scrotum, torsion, tumor and surgery.

The acute pediatric scrotum. Support Center Support Center. Pyocele Most frequently, pyocele occurs as a complication of orchiepidydimitis, particularly in cases where the latter crosses the mesothelial layer of twsticular tunica vaginalis 3or secondarily to a reactive infected hydrocele 6.

Oderda M, Gontero P. Slow growth, as in our case, can be one finding for suspecting a benign lesion. Gas may be present, causing echogenic, specular reflections and shadowing 3. Acute, caused by trauma. Histologic classification of these tumors is complex, and includes seminomas, choriocarcinoma, and a variety of teratomas, or germ cell tumors. Genital squamous-cell carcinoma after PUVA therapy. This lesion, inhomogeneous and multiseptated, had high-signal intensity on T1 Fig.

Intrascrotal cystic mass mimicking a testicular tumor and review of the literature. A 56—year old veteran presented to the emergency room 4 days after he fell and struck his scrotum. Several conditions can cause painless scrotal swelling. Surg; ; 11 1: ABC of general paediatric surgery. The involved scrotal skin was focally inflamed ulcerated. In contrast, patients with hydroceles will have a palpably normal spermatic cord and inguinal ring above the swollen area.