Eldore Luke W, Borries Trevor, Malick Hamza, Mason Kiera, DePrisco Gregory
Medical School, Texas A&M College of Medicine, Dallas, USA.
Diagnostic Radiology, Baylor University Medical Center, Dallas, USA.
Cureus. 2023 Jul 9;15(7):e41609. doi: 10.7759/cureus.41609. eCollection 2023 Jul.
Testicular rupture is a surgical emergency necessitating prompt diagnosis and intervention to prevent irreversible damage. Blunt trauma, including motorcycle collisions, is a common cause of testicular rupture. In the case of multi-trauma, the diagnosis of testicular rupture may be missed in the rush to surgical intervention of more grossly obvious injuries. We present a case of a 24-year-old male who suffered a motorcycle accident and subsequently presented with diffuse abdominal and hip pain. Physical exam and imaging at the emergency department showed multiple pelvic bone fractures, along with a small scrotal injury which was triaged below his pelvic injuries. His pelvic fractures were immediately operated on. Nearly 18 hours after his initial presentation, the patient received a scrotal ultrasound which demonstrated a rupture of the right testicle. Due to this long delay in diagnosis, his urological team opted for non-surgical management and instead employed a more conservative treatment regimen involving pain control, scrotal support, rest, and serial scrotal ultrasounds. This case highlights the importance of timely ultrasound examination for testicular pathology in the setting of multi-trauma and known scrotal injury. Another highlight of this case is the showcase of an uncommon treatment regimen utilizing conservative tactics as opposed to opting for surgical intervention.
睾丸破裂是一种外科急症,需要迅速诊断和干预以防止不可逆转的损害。钝性创伤,包括摩托车碰撞,是睾丸破裂的常见原因。在多发伤的情况下,在急于对更明显的损伤进行手术干预时,可能会漏诊睾丸破裂。我们报告一例24岁男性,他遭遇摩托车事故,随后出现弥漫性腹部和髋部疼痛。急诊科的体格检查和影像学检查显示多处骨盆骨折,同时伴有阴囊小损伤,该损伤在其骨盆损伤之后进行了分诊。他的骨盆骨折立即接受了手术。在初次就诊近18小时后,患者接受了阴囊超声检查,结果显示右侧睾丸破裂。由于诊断延误时间较长,他的泌尿外科团队选择了非手术治疗,而是采用了一种更保守的治疗方案,包括疼痛控制、阴囊支撑、休息和系列阴囊超声检查。该病例突出了在多发伤和已知阴囊损伤情况下及时进行超声检查对睾丸病变的重要性。该病例的另一个亮点是展示了一种不常见的治疗方案,即采用保守策略而非选择手术干预。