片岡 肇一 ¹, 斉藤 豊彦¹, 吉田 英機¹, 渡辺 賀寿雄², 芝木 國雄²

Toshiichi KATAOKA ¹, Toyohiko SAITOU ¹, Hideki YOSHIDA¹, Kazuo WATANABE², Kunio SHIBAKI ²

¹昭和大学泌尿器科学, ²東京専売病院泌尿器科

¹Department of Urology, Showa University School of Medicine, ²Department of Urology, Tokyo Senbai Hospital

キーワード : Color Doppler ultrasonography , Conservative management , Testicular trauma

A 40-year-old man was admitted to this institution complaining of pain and swelling in the right testicle three days after recieving a blow to the scrotum while playing beseball. Color Doppler sonography showed a rupture of tunica albuginea and arterial blood flow in the testis. A hematocele and an approximately 15-mm tear of the tunica albuginea with protrusion of the seminiferous tissue were discovered on exploration. The hematocele was excised and the tunica albuginea was repaired. Presence of blood flow in the testis suggested that the testis could be saved. Recent wide-spread use of ultrasonographic examination has increased the rate of correct diagnosis in cases of testicular trauma to about 70%. Choice between orchiectomy and conservatice management is difficult, however. Nonetheless, Color Dopier ultrasonography is far more useful than B-mode ultrasonography alone in determining the appropriateness of conservative management.