Renal/GU - Testicular Rupture
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27 y/o M presented wit scrotal pain upon awakening after a night of heavy drinking. He could not recall any trauma. Physical exam revealed a tender, swollen, and ecchymotic scrotum. POCUS demonstrates hematocele, as well as (1) disruption of the tunica albuginea, (2) contour abnormality of the testis, and (3) heterogeneous echotexture of testicular parenchyma. These three findings collectively are highly sensitive and specific for testicular rupture1-3, and warrant urgent surgical exploration. Elizabeth Hanson, MD - EM resident, Kings County/SUNY Downstate 1. Deurdulian C, Mittelstaedt CA, Chong WK, Fielding JR. US of acute scrotal trauma: optimal technique, imaging findings, and management. RadioGraphics2007; 27: 357–369. 2. BuckleyJC, McAninch JW. Use of ultrasonography for the diagnosis of testicular injuries in blunt scrotal trauma. J Urol2006; 175: 175–178. 3. Micalle FM, Ahmad I, Ramesh N, Hurley M, McInerney D. Ultrasound features of blunt testicular injury. Injury2001; 32: 23–26.