Testicular dislocation: An uncommon and easily overlooked complication of blunt abdominal trauma☆
Received 12 May 2003; received in revised form 16 July 2003; accepted 18 July 2003.
Abstract
Study objective
We report testicular dislocation as an unusual complication of blunt abdominal trauma.
Methods
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.
Results
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.
Conclusion
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.
aDepartment of Radiology, Chang Gung Memorial Hospital at Kaohsiung, Chang Gung University, Kaohsiung Hsien, Taiwan
bDepartment of Emergency Medicine, Chang Gung Memorial Hospital at Kaohsiung, Chang Gung University, Kaohsiung Hsien, Taiwan
cDepartment of Traumatology, Chang Gung Memorial Hospital at Kaohsiung, Chang Gung University, Kaohsiung Hsien, Taiwan
dDepartment of Radiology, Chang Gung Memorial Hospitals at Linkou and Keelung, Chang Gung University, Taoyuan Hsien and Keelung Hsien, Taiwan
Address for reprints: Sheung-Fat Ko, MD, Department of Radiology, Chang Gung Memorial Hospital, 123, Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien, 833, Taiwan; 886-7-7317123 ext. 2579, fax 886-7-7318762
☆ Author contributions: SFK conceived the study. SFK, CTK, and PPL collected all data and reviewed medical records. SFK, SHN, YLW, CCH, and TYL reviewed imaging studies. SFK drafted the manuscript, and all authors contributed substantially to its revision. SFK takes responsibility for the paper as a whole.
Presented at the European Congress of Radiology, Vienna, Austria, March 7-11, 2003.
The authors report this study did not receive any outside funding or support.
ABSTRACT