Testicular dislocation: an uncommon and easily overlooked complication of blunt abdominal trauma.
We report testicular dislocation as an unusual complication of blunt abdominal trauma.



The computer data bank of Chang Gung Memorial Hospital was searched for the period from 1987 to 2002, and 1,967 male patients with blunt abdominal trauma were admitted to the emergency department. Among these patients, records of 9 patients associated with testicular dislocation were collected. A retrospective review of the clinical records, abdominal computed tomography (CT) results, and subsequent scrotal sonograms was jointly performed by 2 radiologists, an emergency physician, and a trauma surgeon.



Of these 9 patients (age range 6 to 53 years; mean 23 years), 7 patients were in motorcycle crashes, 1 patient had explosive injury, and 1 patient had seat belt injury. Associated testicular dislocation was initially missed in all patients. CT for evaluating blunt abdominal trauma revealed liver lacerations in 2 patients and pancreatic fracture, pancreatitis, bowel perforation, pubic bone fracture, and contralateral inguinal hernia in 1 each. Typical CT findings of testicular dislocation (empty scrotum and displaced testis) were retrospectively seen in 7 patients, but prompt CT diagnosis of testicular dislocation was achieved only in 3 patients, who were subsequently treated with closed manual reduction, obviating surgery. In the remaining 2 patients, CT examination did not include the scrotum and testicular dislocation, which was diagnosed by subsequent sonography. Delayed diagnosis occurred in 6 patients (duration 3 to 60 days; mean 19 days). Five of the patients underwent orchiopexy, and 1 underwent orchiectomy.



In blunt abdominal trauma patients, associated testicular dislocation is easily overlooked. A complete physical examination in the trauma patient, including palpation of both testes, is strongly recommended.
Department of Radiology, Chang Gung Memorial Hospital at Kaohsiung, Chang Gung University, Kaohsiung Hsien, Taiwan. sfatko@adm.cgmh.org.tw
Sheung-Fat
SF
Ko
Shu-Hang
SH
Ng
Yung-Liang
YL
Wan
Chung-Cheng
CC
Huang
Tze-Yu
TY
Lee
Chia-Te
CT
Kung
Po-Ping
PP
Liu
D000007:Abdominal Injuries / Q000150:complications*; D000293:Adolescent; D000328:Adult; D002648:Child; D003951:Diagnostic Errors; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013733:Testicular Diseases / Q000175:diagnosis / Q000209:etiology; D013737:Testis / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000150:complications*