title: Surgically Confirmed Intra- and Extratesticular Hematoma Clinically Mimicing Epididymo-Orchitis and Radiologically Mimicing Traumatic Torsion.
abstract: BACKGROUND
  Scrotal blunt trauma may result in injuries, such as testicular rupture, dislocation, torsion, hematoma, spermatic cord injury or contusion, and epididymal, scrotal, and urethral injuries. Ultrasonography (US) has a crucial role in the evaluation of those kinds of pathologies. Early diagnosis of testicular rupture may lead to the salvaging of the testicle by prompt surgical exploration within 72 h.
  
  
  METHODS
  A 21-year-old male with right scrotal swelling and pain complaints was admitted to another hospital one month ago. Epididymo-orchitis was diagnosed and the patient was given medical treatment. The patient was admitted to our emergency service with ongoing complaints. The patient stated that the pain and swelling suddenly developed after prolonged marching. On US, a large hematoma was detected between the leaves of the tunica vaginalis, and rupture from the lower pole was diagnosed. On color Doppler US, no vascularity was observed in the heterogeneous testicular parenchyma. Traumatic torsion was primarily suggested. Intraoperatively, an extratesticular hematoma, hematocele, and rupture were confirmed but torsion was not found. Because the hematoma entirely replaced the normal parenchyma, orchiectomy was performed.
  
  
  CONCLUSIONS
  Testicular rupture may occur even after moderate sportive action such as prolonged marching. If any delay occurs in diagnosis and/or operation, the coagulum may replace the entire parenchyma. We think that US and clinical findings may sometimes mislead the physicians and cause misdiagnoses, such as inflammation or torsion. In this paper, we present a complex delayed diagnosed example case of testicular rupture clinically mimicing epididymo-orchitis and radiologically mimicing traumatic testicular torsion.
authors.affiliation: Department of Radiology, Sirnak Military Hospital, Sirnak, Turkey.
authors.forename: Sinan
authors.initials: S
authors.lastname: Akay
authors.affiliation: Department of Urology, Dr. Behcet Uz Pediatric Health and Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kaygisiz
authors.affiliation: Department of General Surgery, Sirnak Military Hospital, Sirnak, Turkey.
authors.forename: Muharrem
authors.initials: M
authors.lastname: Oztas
authors.affiliation: Department of General Surgery, Sirnak Military Hospital, Sirnak, Turkey.
authors.forename: Mustafa Suphi
authors.initials: MS
authors.lastname: Turgut
keywords: Hematocele; Spermatic Cord Torsion; Testicular Diseases; Ultrasonography; Ultrasonography, Doppler, Color