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Purpose <p>Pediatric testicular rupture is rare, and detailed descriptions of its ultrasonographic (US) findings with operative correlation remain limited. This paper reviews the characteristic ultrasonographic findings of pediatric testicular rupture and correlates them with operative findings and postoperative outcomes.</p> Methods <p>Among 27 male patients who underwent US for suspected testicular trauma over a 23-year period, four cases with surgically confirmed testicular rupture were retrospectively reviewed. Clinical presentation, physical examination findings, timing of presentation and surgery, preoperative US findings, operative findings, and postoperative outcomes were evaluated.</p> Results <p>The patients ranged in age from 11 to 14&#xa0;years, with two right-sided and two left-sided injuries. Mechanisms of injury included sports-related trauma (n = 2) and physical assault (n = 2). Presenting symptoms included scrotal swelling, scrotal/lower abdominal pain, and vomiting. Physical examination demonstrated scrotal tenderness in all patients, scrotal swelling in three, and erythema in one. The interval from injury to presentation ranged from 2 to 60&#xa0;h (median, 34&#xa0;h), and the interval from injury to surgery ranged from 28 to 130&#xa0;h (median, 54&#xa0;h). All patients demonstrated characteristic US findings suggestive of testicular rupture, including discontinuity of the tunica albuginea, poorly defined testicular margins, heterogeneous echotexture of the extruded testicular parenchyma, and decreased blood flow in the extruded area. Associated findings included intratesticular or scrotal hematoma and scrotal wall thickening. Operative findings confirmed rupture of the tunica albuginea in all cases and correlated well with preoperative US findings. During follow-up (mean, 9&#xa0;months), ipsilateral testicular atrophy developed in three patients, whereas one patient showed preserved testicular volume without abnormal US findings.</p> Conclusion <p>Pediatric testicular rupture demonstrates characteristic ultrasonographic findings that correlate well with operative findings. Recognition of these findings may facilitate early diagnosis and prompt surgical consultation. Because postoperative testicular atrophy may occur despite testicular preservation, continued ultrasonographic follow-up is important.</p> Graphical Abstract <p></p>

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A case series on ultrasonographic findings in pediatric testicular rupture: a comparison with surgical findings

  • 期刊论文

  • 发表日期：

    2026年6月25日

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  • Reiko Okamoto,
  • Mikiko Miyasaka,
  • Ayako Imai,
  • Yoshiyuki Tsutsumi,
  • Shunsuke Nosaka,
  • Yuichi Hasegawa,
  • Satoko Uematsu,
  • Osamu Miyazaki

摘要

Purpose

Pediatric testicular rupture is rare, and detailed descriptions of its ultrasonographic (US) findings with operative correlation remain limited. This paper reviews the characteristic ultrasonographic findings of pediatric testicular rupture and correlates them with operative findings and postoperative outcomes.

Methods

Among 27 male patients who underwent US for suspected testicular trauma over a 23-year period, four cases with surgically confirmed testicular rupture were retrospectively reviewed. Clinical presentation, physical examination findings, timing of presentation and surgery, preoperative US findings, operative findings, and postoperative outcomes were evaluated.

Results

The patients ranged in age from 11 to 14 years, with two right-sided and two left-sided injuries. Mechanisms of injury included sports-related trauma (n = 2) and physical assault (n = 2). Presenting symptoms included scrotal swelling, scrotal/lower abdominal pain, and vomiting. Physical examination demonstrated scrotal tenderness in all patients, scrotal swelling in three, and erythema in one. The interval from injury to presentation ranged from 2 to 60 h (median, 34 h), and the interval from injury to surgery ranged from 28 to 130 h (median, 54 h). All patients demonstrated characteristic US findings suggestive of testicular rupture, including discontinuity of the tunica albuginea, poorly defined testicular margins, heterogeneous echotexture of the extruded testicular parenchyma, and decreased blood flow in the extruded area. Associated findings included intratesticular or scrotal hematoma and scrotal wall thickening. Operative findings confirmed rupture of the tunica albuginea in all cases and correlated well with preoperative US findings. During follow-up (mean, 9 months), ipsilateral testicular atrophy developed in three patients, whereas one patient showed preserved testicular volume without abnormal US findings.

Conclusion

Pediatric testicular rupture demonstrates characteristic ultrasonographic findings that correlate well with operative findings. Recognition of these findings may facilitate early diagnosis and prompt surgical consultation. Because postoperative testicular atrophy may occur despite testicular preservation, continued ultrasonographic follow-up is important.

Graphical Abstract