以陰囊水腫表現之創傷後睪丸破裂：案例報告及文獻回顧

游家豪¹、許軒豪¹、賴宗豪¹、溫玉清^1,2、林雍偉^1,2、林克勳^1,2

1臺北市立萬芳醫院泌尿科－委託財團法人臺北醫學大學辦理

2臺北醫學大學泌尿學科

Posttraumatic testicular rupture mimicking as hydrocele : A case report and literature review

Chia-Hao, You¹, Syuan-Hao Syu¹, Chung-Howe Lai¹, Yu-Ching Wen^1,2 , Yung-Wei Lin^1,2, Ke-Hsun Lin^1,2

1 Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.

2 Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

Introduction:

Hydrocele is a common disease in the practice of urology with abnormal fluid collection between the parietal layer and the visceral layer of the tunica vaginalis. Otherwise, blunt testicular trauma with rupture of albuginea is one of the rare emergencies requiring surgical exploration. Here we presented one case who got testicular rupture after trauma dignosed hydrocele with incidentially finding of testicular rupture during operation.

Presentation of case:

We reported a case of 46-year-old male patient undergoing sport injury with painful post-traumatic hydrocele which was diagnosed with scrotal echography. Due to progression with gradual enlargement and pain, the patient agreed with surgical intervention. During the operation, incidental finding of testis rupture with remodeling of tunica albuginea was noted.  The postoperative course was uneventful. The patient was discharged the next day after the surgery. Pathology result of resected tissue disclosed presence of seminiferous tubules with spermatogenesis, approving the condition of testis rupture. No recurrent hydrocele was noted during outpatient department following up.

Discussion and conclusion:

Acute scrotum with suspicious of testis rupture required emergent operation of exploration and scrotal echography could provide as a rapid screen tool. Severe pain with progression intra-testicular hematoma is also a common presentation. However, the described case report remind us of the possibility of misdiagnosis of echography due to no hematoma nor scrotal skin echymosis for three weeks.