PMC4630954_01
(A, B) The longitudinal gray-scale US image shows discontinuity in the tunica albuginea, which suggests rupture at the inferior pole of the testicle (arrows). A large, crescent-shaped, organized hematoma located between the leaves of the tunica vaginalis is readily seen in both US scan and corresponding intraoperative image (asterisks).
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The hematoma had the anteroposterior diameter of 2 cm, and a complicated hydrocele appearance between the leaves of the tunica vaginalis (Figure 1A, 1B). At the inferior pole of the testicle, discontinuity in the tunica albuginea was seen, and rupture was diagnosed (Figures 1, 3).
The longitudinal color Doppler US image (A) shows no internal vascularity in the prominently heterogeneous-hypoechogeneic testicular parenchyma. On the other color Doppler US image (B), healthy left testicle with normal homogeneous parenchyma and internal vascularity is seen. The organized hematoma located between the leaves of the tunica vaginalis is also observed (asterisks).
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Its parenchyma was prominently heterogeneous on the gray-scale examination, and no vascularity was detected on color Doppler US (Figure 2).
The rupture site (arrows) and the organized coagulum (pentagram) at the lower pole of the normal-colored testicle are observed in the corresponding intraoperative photo taken after cleaning the hematoma located between the leaves of the tunica vaginalis.
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At the inferior pole of the testicle, discontinuity in the tunica albuginea was seen, and rupture was diagnosed (Figures 1, 3). The organized coagulum protruded from the testicle parenchyma directly from the ruptured site (Figure 3).