蛋蛋爆出來─一個罕見的陰囊創傷併暴露性睪丸異位
黃柏仁1、黃建勳1、邱逸淳1,2,3、邱文祥1,2,3
1臺北市立聯合醫院忠孝院區 外科部 泌尿外科；2臺北市立聯合醫院仁愛院區 外科部 泌尿外科；3國立陽明大學 醫學院泌尿學科
A testis bursted out─ a rare scrotal trauma with exposed testicular dislocation case report and literature review
Po-Jen Huang1, Chien-Hsun Huang1, Yi-Chun Chiu1,2,3, Allen W. Chiu1,2,3
1Division of Urology, Department of Surgery, Taipei City Hospital, Zhong-xiao Branch
2Division of Urology, Department of Surgery, Taipei City Hospital, Ren-Ai branch
3Department of Urology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Purpose: Traumatic testicular dislocation is rare, especially with testis protruding out of the scrotum. Most dislocations occurred with other major trauma. Herein we report a case of bursted testicular dislocation without any other injury.
Case report: A 18-year-old man hit on a pillar during riding a motorcycle. His chief complaint was mild left scrotal pain. Vital sign was stable at emergency department. No wound, ecchymosis, contusion, or bone fracture was found (except some blood on underpants). Left testis was exposed out of the scrotum (pic1). Emergent scrotal repair was performed under spinal anesthesia. During the operation, we found bursted scrotal skin wound about 2 centimeter in length, and the tunica vaginalis of the exposed testis was intact. Post-operative ultrasonography showed intact testicles with normal blood flow and no hematoma nor hydrocele was noted.
Discussion: According to the literature we can query currently, most traumatic testicular dislocations are related to direct external impact, often accompanying with severe pelvic or systemic trauma. There were very few cases of only testicles bursting out of scrotum. This patient was wearing tight jeans, so presumably it was caused by strong shearing force which produced by powerful impact and increased frictional force provided by the tight jeans. Such blunt trauma in limited space produced impact that made the testicle protrude out of the scrotum. This kind of traumatic bursted testicular dislocation is extremely rare, so we hereby report.
Conclusion: Traumatic protruding dislocation of the testis without major trauma is rare. Emergent scrotal repair is a feasible method for patients with traumatic testicular dislocation.